2021 direktoryo ng provider at parmasya blue shield

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San Diego County H0148_20_141A_PNO_SD_TA_Accepted 11/22/2020 Direktoryo ng Provider at Parmasya Blue Shield Promise Cal MediConnect Plan (Medicare-Medicaid Plan) 202 1

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Page 1: 2021 Direktoryo ng Provider at Parmasya Blue Shield

San Diego County

H0148_20_141A_PNO_SD_TA_Accepted 11/22/2020

Direktoryo ng Provider at Parmasya Blue Shield Promise Cal MediConnect Plan

(Medicare-Medicaid Plan)

2021

Page 2: 2021 Direktoryo ng Provider at Parmasya Blue Shield
Page 3: 2021 Direktoryo ng Provider at Parmasya Blue Shield

Blue Shield Promise Cal MediConnect Plan | 2021 Direktoryo ng Provider at Botika

Panimula

Isinasama nitong Direktoryo ng Provider at Parmasya ang impormasyon tungkol sa mga uri

ng provider at parmasya sa Blue Shield Promise Cal MediConnect Plan at mga lista ng lahat

ng provider at parmasya ng plan hanggang sa petsa nitong Direktoryo. Naglalaman ang

lista ng mga address at impormasyon sa pakikipag-ugnayan ng provider at parmasya pati

na rin ng iba pang detalye gaya ng mga araw at oras ng operasyon, mga espesyalidad, at

mga kasanayan. Makikita ang mga pangunahing salita at ang kanilang mga kahulugan sa

pagkakasunud-sunod ayon sa alpabeto sa huling kabanata ng Handbook ng Miyembro.

Kung mayroon kang mga tanong, pakitawagan ang Blue Shield Promise Cal MediConnect Plan sa

1-855-905-3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. pitong araw sa isang linggo. Libre ang tawag. Para

sa karagdagang impormasyon, bumisita sa www.blueshieldca.com/promise/calmediconnect.

I

Page 4: 2021 Direktoryo ng Provider at Parmasya Blue Shield

II

Page 5: 2021 Direktoryo ng Provider at Parmasya Blue Shield

Talaan ng mga Nilalaman A. Mga Pagtatatuwa ng Pananagutan ........................................................................VI

B. Mga Provider ................................................................................................................. IX

B1. Mahahalagang termino ........................................................................................ IX

B2. Pagpili ng Primary Care Physician (PCP) .............................................................X

B3. Mga pangmatagalang serbisyo at suporta (Long-term services and supports

LTSS) ................................................................................................................................XI

B4. Paano tukuyin ang mga provider sa network ng Blue Shield Promise Cal

MediConnect Plan .......................................................................................................XII

B5. Paano mahanap ang mga provider ng Blue Shield Promise Cal MediConnect

Plan sa vinyong lugar ...................................................................................................XIII

B6. Listahan ng mga provider sa network .................................................................XV

B7. Ang iyong Mga Karagdagang Benepisyo ..........................................................XV

C. Listahan ng network ng mga botika .........................................................................XVII

C1. Paano tukuyin ang mga botika sa network ng Blue Shield Promise Cal

MediConnect Plan .......................................................................................................XVII

C2. Mga pangmatagalang supply ng mga reseta .................................................XVIII

D. Mga provider sa network ng Blue Shield Promise Cal MediConnect Plan

BLUE SHIELD PROMISE HEALTH PLAN DIRECT

COMMUNITY CARE IPA LLC

GREATER TRI CITIES IPA MEDICAL GROUP INC

HEALTH EXCEL IPA INC

PRIMARY CARE ASSOCIATES OF CALIFORNIA OF SAN DIEGO

SHARP COMM MEDICAL GROUP DUAL PLUS-CHULA VISTA

SHARP COMM MEDICAL GROUP DUAL PLUS-CORONADO

Mga espesyalista ..............................................................................................................1

Mga pangunahing doktor sa pangangalaga ..............................................................12

Mga espesyalista ..............................................................................................................29

Mga pangunahing doktor sa pangangalaga ..............................................................284

Mga espesyalista ..............................................................................................................288

Mga pangunahing doktor sa pangangalaga ..............................................................296

Mga espesyalista ..............................................................................................................331

Mga pangunahing doktor sa pangangalaga ..............................................................558

Mga espesyalista ..............................................................................................................576

Mga pangunahing doktor sa pangangalaga ..............................................................608

Mga espesyalista ..............................................................................................................615

Kung mayroon kang mga tanong, pakitawagan ang Blue Shield Promise Cal MediConnect Plan

sa 1-855-905-3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. pitong araw sa isang linggo. Libre ang tawag.

Para sa karagdagang impormasyon, bumisita sa

www.blueshieldca.com/promise/calmediconnect.

III

Page 6: 2021 Direktoryo ng Provider at Parmasya Blue Shield

Mga pangunahing doktor sa pangangalaga ..............................................................642

SHARP COMM MEDICAL GROUP DUAL PLUS-GRAYBILL

SHARP COMM MEDICAL GROUP DUAL PLUS-GROSSMONT

SHARP COMM MEDICAL GROUP DUAL PLUS-INLAND NORTH

SHARP COMM MEDICAL GROUP DUAL PLUS-METRO

UCSD MEDICAL GROUP

Mga espesyalista ..............................................................................................................644

Mga pangunahing doktor sa pangangalaga ..............................................................686

Mga espesyalista ..............................................................................................................693

Mga pangunahing doktor sa pangangalaga ..............................................................732

Mga espesyalista ..............................................................................................................737

Mga pangunahing doktor sa pangangalaga ..............................................................790

Mga espesyalista ..............................................................................................................792

Mga pangunahing doktor sa pangangalaga ..............................................................825

Mga espesyalista ..............................................................................................................829

Mga espesyalista ..............................................................................................................879

D2. Acupuncture, Dental, Kalusugan sa bahay, Kalusugang pangkaisipan, at

Tagapagbigay ng Vision

Acupuncture .....................................................................................................................1073

Kalusugan sa bahay .........................................................................................................1218

Tagapagbigay ng Dental ................................................................................................1223

Kalusugang pangkaisipan ...............................................................................................1224

Tagapagbigay ng Vision ..................................................................................................1255

D3. Mga Ospital, Mga Serbisyo sa Suporta sa Pangmatagalang, Mga Pasilidad sa

Kalusugan ng Isip, Mga Pasilidad sa Pag-aalaga at mga Skilled Nursing Facility

Mga Ospital .......................................................................................................................1319

Mga Serbisyo sa Suporta sa Pangmatagalang ............................................................1323

Mga Pasilidad sa Kalusugan ng Isip ...............................................................................1324

Mga Pasilidad sa Pag-aalaga ........................................................................................1338

E. Mga botika sa network ng Blue Shield Promise Cal MediConnect Plan

E1. Tingian at chain ng mga botika ............................................................................1359

E2. Mail order na parmasya ............................................................................................1399

E3. Mga home infusion na botika ...............................................................................1400

E4. Mga Botika para sa pangmatagalang pangangalaga ...................................1401

E5. Indian Health Service/ Tribal/ Urban Indian Health Program (I/T/U) pharmacies

1405

F. Index of Mga Tagapagkaloob at mga parmasya

F1. Mga Tagapagkaloob .............................................................................................1406

Kung mayroon kang mga tanong, pakitawagan ang Blue Shield Promise Cal MediConnect Plan

sa 1-855-905-3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. pitong araw sa isang linggo. Libre ang tawag.

Para sa karagdagang impormasyon, bumisita sa

www.blueshieldca.com/promise/calmediconnect.

IV

Page 7: 2021 Direktoryo ng Provider at Parmasya Blue Shield

F2. Mga parmasya ........................................................................................................1433

Kung mayroon kang mga tanong, pakitawagan ang Blue Shield Promise Cal MediConnect Plan

sa 1-855-905-3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. pitong araw sa isang linggo. Libre ang tawag.

Para sa karagdagang impormasyon, bumisita sa

www.blueshieldca.com/promise/calmediconnect.

V

Page 8: 2021 Direktoryo ng Provider at Parmasya Blue Shield

A. Mga Pagtatatuwa ng Pananagutan

� Ang Blue Shield Promise Cal MediConnect Plan ay isang planong pangkalusugan

na nakikipagkontrata sa parehong Medicare at Medi-Cal upang ibigay ang mga

benepisyo ng parehong programa sa mga nagpapatala.

� Ang Listahan ng Mga Sinasaklaw na Gamot at/o mga network ng botika at provider

ay maaaring magbago sa buong taon. Padadalhan ka namin ng abiso bago kami

gumawa ng pagbabagong makakaapekto sa iyo.

� Maaaring magbago ang mga benepisyo at/o copay sa Enero 1 ng bawat taon.

� Kabilang sa Direktoryo ang mga provider na nagbibigay ng mga serbisyo sa parehong

Medicare at Medi-Cal.

� Nakatala sa Direktoryong ito ang mga health care professional (tulad ng mga doktor,

nurse practitioner, at psychologist), pasilidad (tulad ng mga ospital o klinika), at provider

ng suporta (tulad ng mga provider ng Kalusugan sa Araw ng Mga Nasa Hustong Gulang

at Kalusugan sa Tahanan) na maaari mong makita bilang miyembro ng Blue Shield

Promise Cal MediConnect Plan. Itinatala rin namin ang mga botikang maaari mong

gamitin upang makuha ang iyong mga resetang gamot.

� Tutukuyin namin ang mga grupong ito bilang “mga provider ng network” sa

Direktoryong ito. Lumagda ang mga provider na ito ng kontrata sa amin upang

magbigay sa iyo ng mga serbisyo. Ito ay isang listahan ng mga provider sa network ng

Blue Shield Promise Cal MediConnect Plan para sa San Diego County.

Kung mayroon kang mga tanong, pakitawagan ang Blue Shield Promise Cal MediConnect Plan sa

1-855-905-3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. pitong araw sa isang linggo. Libre ang tawag. Para

sa karagdagang impormasyon, bumisita sa www.blueshieldca.com/promise/calmediconnect.

VI

Page 9: 2021 Direktoryo ng Provider at Parmasya Blue Shield

English: If you speak English, language assistance services, free of charge, are

available to you. Call 1-855-905-3825 (TTY users should call 711). 8:00 a.m –

8:00 p.m., seven days a week. The call is free.

Español

(Spanish):

ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de

asistencia lingüística. Llame al Blue Shield Promise Cal-MediConnect

1-855-905-3825 (TTY: 711) De 8:00 a.m. a 8:00 p.m., los siete días de la semana.

繁體中文 ( Chinese):

繁體中文 (Chinese): 注意:如果您使用繁體中文,您可以免費獲得語言援助服

務。請致電 Blue Shield Promise Cal-MediConnect 1-855-905-3825 (TTY: 711) 每周七天办公,每天早上 8:00 至晚上 8:00。这是免费电话。

Tiếng Việt

(Vietnamese):

CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho

bạn. Gọi số Blue Shield Promise Cal-MediConnect 1-855-905-3825 (TTY: 711) 8 giờ sáng–8 giờ tối, 7 ngày trong tuần. HOẶC Ban.

Tagalog

(Tagalog – Filipino):

PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga

serbisyo ng tulong sa wika nang walang bayad. Tumawag sa Blue Shield Promise

Cal-MediConnect 1-855-905-3825 (TTY: 711) Mula 8am-8pm, 7 araw sa isang lingo.

한국어 (Korean):

주의 : 한국어를 사용하시는 경우 , 언어 지원 서비스를 무료로 이용하실 수 있습 니다 . Blue Shield PromiseCal-MediConnect 1-855-905-3825 (TTY: 711) 번으로 전화해 주십시오 . 번으로 전화해 주십시오 , 오후 8 시 , 7 일 주일 오전 8 시 .

Հայերեն (Armenian):

�ՇԱԴՐ�ԹՅ�Ն՝ Եթե խոս�մ եք հայերեն, ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցո թյան ծառայո թյո ններ:

Զանգահարեք Blue Shield Promise Cal-MediConnect 1-855-905-3825 (TTY

(հեռատիպ)՝ 711) Ից 8:00 – 20:00, շաբաթը յոթ օր

یسراف(Persian/Farsi):

با . باشد می فراھم شما برای رایگان بصورت زبانی تسھیلات کنید، می گفتگو فارسی زبان بھ اگر : توجھ با . باشد (TTY: 711) ھفتھ روزه ھمھ شب، 8 تا صبح . 8 بگیرید تماس 1-855-905-3825

Русский (Russian):

ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните Blue Shield Promise Cal-MediConnect

1-855-905-3825 (телетайп: 711) С 8:00 до 20:00, без выходных.

日本語 (Japanese):

注意事項:日本語を話される場合、無料の言語支援をご利用いただけま

す。 Blue Shield Promise Cal-MediConnect 1-855-905-3825 (TTY:711) まで、お電話にてご連絡ください。毎日 8am~ 8pm

ةيبرعلا(Arabic):

بالرقم اتصل . لك متوفرة ، ا ً مجان ، اللغة مساعدة خدمات فإن ، العربیة تتحدث كنت إذاً ً صباح 8:00 .(711 بالرقم الاتصال مستخدمي على یجب TTY ( 1-855-905-3825 ،مساء - 8:00 ا

مجانیة المكالمة . الأسبوع في أیام سبعة.

ਪੰਜਾਬੀ (Punjabi):

ਿਧ�� ਿ��: ਜੇ ਤੁਸੀਂ ਪੰਜਾਬੀ ਬੋਲ�ੇ ਹੋ� ਤਾਂ �ਾ�ਾ ਿਵੱਚ ਸਹਾਇਤਾ ਸੇਵਾ ਤੁਹਾਡੇ ਲਈ ਮੁਫਤ ਉਪਲਬਧ ਹੈ। Blue Shield Promise Cal-MediConnect 1-855-905-3825

(TTY:711) ‘ਤੇ ਕਾਲ ਕਰੋ।.ਸਵੇਰੇ 8 ਵਜੇ ਤੋਂ �ਾਮ 8 ਵਜੇ ਤੱਕ� ਹ�ਤੇ ਿਵਚ 7 ਿ��

�ខែរ (Cambodian/Khmer):

��

� �

�បែយ័ត: បែសិនបើអកនិ�យ��អែសែប៉ែញអក�នសែ�កមជំនួយ�� ឥតគិតថែ។ ទូរស័ព�� Cal-MediConnect 1-855-905-3825 (TTY: 711)

�ប់ពីម៉ែង 8:00 ពែឹក។ ម៉ែង 8 ពែឹកម៉ែង 7 ថែកុងមួយសបែហ៍។

Kung mayroon kang mga tanong, pakitawagan ang Blue Shield Promise Cal MediConnect Plan sa

1-855-905-3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. pitong araw sa isang linggo. Libre ang tawag. Para

sa karagdagang impormasyon, bumisita sa www.blueshieldca.com/promise/calmediconnect.

VII

Page 10: 2021 Direktoryo ng Provider at Parmasya Blue Shield

� Makukuha mo nang libre ang dokumentong ito sa iba pang format, gaya ng malalaking letra, braille, o audio. Tawagan ang Member Services sa 1-855-905-3825 (TTY: 711) 8:00

a.m. to 8:00 p.m. pitong araw sa isang linggo. Libre ang tawag.

� Maaari kang humiling na makakuha ng mga materyales sa wikang bukod sa English o

sa isang alternatibong format ngayon at sa hinaharap. Upang humiling, mangyaring

makipag-ugnayan sa Member Services ng Blue Shield Promise Cal MediConnect Plan. .

� Napapanahon ang listahang ito sa petsang 7/1/2021, ngunit kailangan mong malaman na:

• May ilang provider sa network ng Blue Shield Promise Cal MediConnect Plan na maaaring nadagdag o naalis mula sa aming network pagkatapos malimbag ang Direktoryong ito.

• May ilang provider ng Blue Shield Promise Cal MediConnect Plan sa aming network na maaaring hindi na tumatanggap ng mga bagong miyembro. Kung nahihirapan kang maghanap ng provider na tatanggap ng mga bagong miyembro, tumawag sa Member Services at 1-855-905-3825 (TTY: 711) ay tutulungan ka namin.

• Upang makuha ang pinakanapapanahong impormasyon tungkol sa mga provider sa network ng Blue Shield Promise Cal MediConnect Plan sa iyong lugar, bumisita sa www.blueshieldca.com/promise/calmediconnect o tumawag sa Member Services sa

1-855- 905-3825(TTY: 711), 8:00 a.m. to 8:00 p.m. pitong araw sa isang linggo. Libre ang tawag.

Nakalista ang mga doktor at iba pang health care professional sa network ng Blue

Shield Promise Cal MediConnect Plan’s sa pahina 1 - 1072. Nakalista ang

mga botika sa aming network sa pahina 1358 - 1405. Magagamit mo ang Indise sa likod ng Direktoryo upang mahanap ang pahina kung saan nakalista ang

provider o botika.

Kung mayroon kang mga tanong, pakitawagan ang Blue Shield Promise Cal MediConnect Plan sa

1-855-905-3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. pitong araw sa isang linggo. Libre ang tawag. Para

sa karagdagang impormasyon, bumisita sa www.blueshieldca.com/promise/calmediconnect.

VIII

Page 11: 2021 Direktoryo ng Provider at Parmasya Blue Shield

B. Mga Provider

B1. Mahahalagang termino

Ipinapaliwanag sa seksyong ito ang mahahalagang terminong makikita mo sa aming

Direktoryo ng Provider at Botika.

• Ang Mga Provider ay mga health care professional at provider ng suporta tulad

ng mga doktor, nars, pharmacist, therapist at iba pang taong nagbibigay ng

pangangalaga at mga serbisyo. Kabilang sa Mga Serbisyo ang medikal na

pangangalaga, mga pangmatagalang serbisyo at suporta (LTSS), supply, resetang

gamot, kagamitan at iba pang serbisyo.

○ Kabilang din sa terminong mga provider ang mga pasilidad tulad ng mga

ospital, klinika at iba pang lugar na nagbibigay ng serbisyong medikal,

kagamitang medikal at mga pangmatagalang serbisyo at suporta.

○ Ang mga provider na bahagi ng network ng aming plano ay tinatawag na

mga provider sa network.

• Ang mga provider sa network ay ang mga tagapagbigay ng serbisyo na

nakipagkontrata sa amin upang magbigay ng mga serbisyo sa mga miyembro sa

aming plano. Sa pangkalahatan, direkta kaming sinisingil ng mga provider sa aming

network para sa pangangalagang ibinibigay nila sa iyo. Kapag nagpatingin ka sa

isang provider na nasa network, karaniwang: wala kang babayaran para sa mga

saklaw na serbisyo.

• Ang Primary Care Physician (PCP) ay isang internist, family practitioner, general

practitioner, o espesyalistang nagbibigay sa iyo ng regular na pangangalagang

pangkalusugan. Itatago ng iyong PCP ang mga medikal na talaan mo at malalaman

ang iyong mga pangangailangang pangkalusugan sa paglipas ng panahon.

Bibigyan ka rin ng iyong PCP ng referral kung kailangan mong makakita ng

espesyalista o iba pang provider.

• Ang mga espesyalista ay mga doktor na nagbibigay ng serbisyo ng

pangangalagang pangkalusugan para sa partikular na sakit o bahagi ng katawan.

Mayroong maraming uri ng espesyalista. Narito ang ilang halimbawa:

○ Pangangalaga ng mga oncologist para sa mga pasyenteng may kanser.

○ Nangangalaga ang mga cardiologist ng mga pasyenteng may mga kondisyon

sa puso.

○ Nangangalaga ang mga orthopedist ng mga pasyenteng may mga partikular

na kondisyon sa buto, kasukasuan, o kalamnan.

• Ang Medikal na pangkat o hiwalay na samahan ng mga doktor (independent

physician association, IPA) ay isang organinasyong binuo sa bisa ng batas sa

California na nakikipagkontrata sa mga planong pangkalusugan para maghatid

o mag-asikaso para sa pagkakaloob ng mga serbisyo sa pangangalagang

pangkalusugan sa mga nakatala sa planong pangkalusugan.

Kung mayroon kang mga tanong, pakitawagan ang Blue Shield Promise Cal MediConnect Plan sa

1-855-905-3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. pitong araw sa isang linggo. Libre ang tawag. Para

sa karagdagang impormasyon, bumisita sa www.blueshieldca.com/promise/calmediconnect.

IX

Page 12: 2021 Direktoryo ng Provider at Parmasya Blue Shield

• Maaari kang mangailangan ng referral upang magpatingin sa isang espesyalista o sa

kaninuman na hindi mo PCP. Nangangahulugan ang referral na dapat kang bigyan

ng pag-apruba ng iyong primary care physician (PCP) para magpatingin sa ibang

doktor maliban sa iyong PCP. Kung hindi ka makakuha ng referral, maaaring hindi

saklawan ng Blue Shield Promise Cal MediConnect Plan ang serbisyo.

○ Hindi kailangan ng referral mula sa aming plano para sa:

– Emergency na pangangalaga;

– Pangangalagang maagap na kailangan;

– Mga serbisyo ng dialysis ng bato na natatanggap mo sa isang pasilidad ng

dialysis na Medicare-certifed kapag nasa labas ka ng lugar ng serbisyo ng

plano; o

– Mga serbisyo mula sa espesyalista ng kalusugan ng kababaihan.

– Lahat ng serbisyo ng pag-iwas sa sakit na nasasaklaw ng Medicare, kabilang

ang mga pagsusuri at bakuna.

• Dagdag pa rito, kung karapat-dapat kang makakuha ng mga serbisyo mula sa mga

Indian na provider ng kalusugan, maaari mong puntahan ang mga provider na ito

nang walang referral. Dapat naming bayaran ang Indian na provider ng kalusugan

para sa mga serbisyong iyon kahit na wala sila sa network ng aming plano.

○ Mababasa ang higit pang impormasyon tungkol sa mga referral sa Kabanata 3

ng Handbook ng Miyembro.

• May access ka rin sa isang Coordinator ng Pangangalaga at team ng pangangalaga

na may tulong ka sa pagpili.

○ Tinutulungan ka ng Coordinator ng Pangangalaga (Care Navigator) na

pamahalaan ang iyong mga medikal na provider at serbisyo.

○ Nagsisimula ang Team ng Pangangalaga sa pakikipag-ugnayan sa pagitan mo

at ng iyong PCP. Maaaring kabilangan ng Team ng Pangangalaga ang isang

tagapangalaga, Coordinator ng Pangangalaga, espesyalista, at iba pa, batay

sa antas ng pangangailangang lumalabas sa iyong Plano ng Pangangalaga.

Nagtutulungan ang lahat ng nasa team ng pangangalaga upang tiyaking

naka-coordinate ang pangangalaga sa iyo. Ang ibig sabihin nito ay tinitiyak

nilang minsan lang ginagawa ang mga pagsusuri at lab at naibabahagi ang

mga resulta sa mga naaangkop na provider. Ibig sabihin din nito na alam

dapat ng iyong PCP ang lahat ng iniinom mong gamot upang mabawasan

niya ang anumang negatibong epekto. Magtutulungan ang iyong Team

ng Pangangalaga upang bumuo, ipatupad at panatilihin ang iyong Plano

ng Pangangalaga. Laging hihingi ng iyong pahintulot ang iyong PCP bago

ibahagi ang iyong impormasyong medikal sa ibang mga provider.

B2. Pagpili ng Primary Care Physician (PCP)

Makakakuha ka ng mga serbisyo sa anumang provider na nasa aming network at

tumatanggap ng mga bagong miyembro.

Kung mayroon kang mga tanong, pakitawagan ang Blue Shield Promise Cal MediConnect Plan sa

1-855-905-3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. pitong araw sa isang linggo. Libre ang tawag. Para

sa karagdagang impormasyon, bumisita sa www.blueshieldca.com/promise/calmediconnect.

X

Page 13: 2021 Direktoryo ng Provider at Parmasya Blue Shield

Una, kakailanganin mong pumili ng Primary Care Physician. Maaaring espesyalista ang

magsilbing iyong PCP. Maaari kang pumili ng isang espesyalista bilang iyong PCP kung

sumasang-ayon ang espesyalista na ibigay ang lahat ng serbisyo na ibinibigay ng PCP ayon

sa kaugalian. Upang hilingin na ang iyong espesyalista ang maging PCP mo, makipag-

ugnayan sa Blue Shield Promise Cal MediConnect Plan Member Services.

Kaanib ang mga PCP ng aming plano sa mga medikal na pangkat. Kapag pumili ka ng

iyong PCP, pinipili mo na rin ang kaanib na medikal na pangkat. Ibig sabihin, ire-refer ka ng

iyong PCP sa mga espesyalista o serbisyong kaanib din ng kanyang medikal na pangkat.

• Kung mayroong partikular na espesyalista o ospital na gusto mong gamitin,

mahalagang tingnan kung kaanib sila sa medikal na pangkat ng iyong PCP. Maaari

kang tumingin sa direktoryong ito, o magtanong sa Member Services ng Blue

Shield Promise Cal MediConnect Plan upang suriin kung ang gusto mong PCP ay

gumagawa ng mga referral sa espesyalistang iyon o ginagamit ang ospital na iyon.

• Kung hindi ka mananatili sa medikal na pangkat ng iyong PCP, maaaring hindi

saklawan ng Blue Shield Promise Cal MediConnect Plan ang serbisyo.

Upang pumili ng PCP, pumunta sa listahan ng mga doktor sa pahina

1 - 1072 at pumili ng doktor:

• na ginagamit mo na, o

• na inirekomenda ng isang taong pinagkakatiwalaan mo, o

• na ang mga opisina ay madali mong mapupuntahan.

• Kung gusto mo ng tulong sa pagpili ng PCP, pakitawagan ang Member Services sa

1-855- 905-3825, 8:00 a.m. to 8:00 p.m. pitong araw sa isang linggo. Libre ang tawag

(TTY: 711). O, bumisita sa www.blueshieldca.com/promise/calmediconnect.

• Kung mayroon kang mga tanong tungkol sa kung babayaran namin ang anumang

medikal na serbisyo o pangangalagang iyong gusto o kailangan, tumawag sa

Customer Care at magtanong bago mo makuha ang serbisyo o pangangalaga.

B3. Mga pangmatagalang serbisyo at suporta (Long-term services and supports, LTSS)

Bilang miyembro ng Blue Shield Promise Cal MediConnect Plan, maaari kang makakuha

ng mga pangmatagalang serbisyo at suporta (LTSS), tulad ng pangangalagang

pangkalusugan sa araw sa mga center na nagbibigay ng nursing, therapy, mga aktibidad

at pagkain sa mga taong may mga partikular na malubhang kundisyon sa kalusugan o

kundisyon sa kalusugan ng pag-iisip; Mga Pansuportang Serbisyo sa Tahanan (In-Home

Supportive Services, IHSS), para sa mga taong kailangan ng personal na pangangalaga

(o/at) tulong upang mabuhay nang ligtas sa tahanan; Programa ng Maraming

Serbisyo sa Matatanda (Multipurpose Senior Services Program, MSSP), nagbibigay ng

social na pamamahala at pamamahala sa pangangalagang pangkalusugan, para

sa matatandang kliyenteng maaaring ipasok sa nursing facility na gustong manatili sa

komunidad na nagbibigay ng medikal na kagamitan at supply tulad ng mga lampin at

serbisyo ng medikal na transportasyon. Tinutulungan ng LTSS ang mga tao na kailangan ng

tulong sa mga pang-araw-araw na gawain tulad ng pagligo, pagbihis, paghahanda ng

pagkain at pag-inom ng gamot. Karamihan sa mga serbisyong ito ay ibinibigay sa iyong

tahanan o sa komunidad mo ngunit maaaring ibigay sa isang nursing home o ospital.

Kung mayroon kang mga tanong, pakitawagan ang Blue Shield Promise Cal MediConnect Plan sa

1-855-905-3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. pitong araw sa isang linggo. Libre ang tawag. Para

sa karagdagang impormasyon, bumisita sa www.blueshieldca.com/promise/calmediconnect.

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Kabilang sa mga serbisyong ito ang Mga Serbisyo sa Komunidad para sa Nasa Hustong

Gulang (Community-Based Adult Services, CBAS).

Ang CBAS ay isang programang pangkalusugan sa araw na nakabatay sa komunidad na

nagbibigay ng mga serbisyo sa mas matatandang tao at mga taong nasa hustong gulang

na may malubhang kundisyong medikal, kognitibo, o kalusugan sa pag-iisip at/o mga

kapansanang nanganganib na mangailangan ng pangangalagang institusyonal.

Upang mag-apply para sa CBAS, mangyaring tumawag sa Blue Shield Promise Cal

MediConnect Plan 1-855-905-3825 (TTY: 711), 8:00 a.m. hanggang 8:00 p.m. pitong araw sa

isang linggo.

Kabilang sa iba pang pangmatagalang serbisyo at suporta na ibinibigay ng Blue Shield

Promise Cal MediConnect Plan ang Multipurpose Senior Services Program (MSSP). Ang MSSP

ay isang Medicaid Waiver na programang pangangasiwa ng kaso para sa matatanda na

edad 65 at mas matanda na karapat-dapat para sa Medi-Cal at maaaring mapatunayan

para sa paglalagay sa isang pasilidad ng pagkalinga (nursing facility) ngunit nagnanais

na manatiling naninirahan sa komunidad. Nakikipagtulungan ang mga Tagapamahala

ng Pangangalaga ng MSSP sa mga benepisyaryo, sa mga miyembro ng kanilang

pamilya, at sa medical team upang tukuyin at isaayos ang mga serbisyo sa tahanan; Ang

Pangmatagalang Pangangalaga/Taga-ingat (Long-Term Care/Custodial, LTC) ay ang

pagbibigay ng mga serbisyong pangangalagang medikal, pakikisalamuha at personal

na ibinibigay sa mga tumatanggap ng Medi-Cal na hindi makapamuhay nang ligtas sa

tahanan ngunit hindi kailangang maging nasa ospital. Inilalagay ang mga indibidwal sa

antas ng pangangalaga na pinakaangkop para sa kanilang mga pangangailangang

medikal at kabilang ang mga Pasilidad ng may Kasanayang Pagkalinga na (Skilled Nursing

Facilities, SNF), Mga Pasilidad para sa Sub-Acute, at Mga Pasilidad na Intermediate Care.

Upang maghanap ng mga provider ng mga serbisyong ito, pumunta sa pahina

1323 sa Direktoryong ito.

Ang buong listahan ng mga serbisyong ito ay makikita sa Kabanata 4 ng iyong Handbook

ng Miyembro.

B4. Paano tukuyin ang mga provider sa network ng Blue Shield Promise Cal MediConnect

Plan

Dapat mong makuha ang lahat ng iyong nasasaklaw na serbisyo mula sa mga provider sa

loob ng aming network na kaanib sa medikal na pangkat ng iyong PCP. Kung pupunta ka

sa mga provider na wala sa network ng Blue Shield Promise Cal MediConnect Plan at hindi

kaanib sa medikal na pangkat ng iyong PCP (nang walang paunang awtorisasyon o pag-

apruba galing sa amin), ikaw ang magbabayad ng singilin.

Ang paunang awtorisasyon ay isang pag-apruba mula sa Blue Shield Promise Cal

MediConnect Plan bago ka makakuha ng partikular na serbisyo o gamot o mag-

patingin sa isang provider na wala sa network. Maaaring hindi saklawin ng Blue Shield

Promise Cal MediConnect Plan ang serbisyo o gamot kung hindi ka maaaprubahan.

Ang mga pagbubukod sa panuntunang ito ay kapag kailangan mo ng maagap o pang-

emergency na pangangalaga o dialysis at hindi makapunta sa isang provider sa plano,

gaya ng kapag wala ka sa iyong tahanan. Maaari ka ring lumabas sa plano o sa iyong

Kung mayroon kang mga tanong, pakitawagan ang Blue Shield Promise Cal MediConnect Plan sa

1-855-905-3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. pitong araw sa isang linggo. Libre ang tawag. Para

sa karagdagang impormasyon, bumisita sa www.blueshieldca.com/promise/calmediconnect.

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medikal na pangkat ng PCP kung pahihintulutan ka muna ng Blue Shield Promise Cal

MediConnect Plan.

Maaari kang mangailangan ng referral upang magpatingin sa taong hindi Primary

Care Physician. Marami pang impormasyon tungkol sa mga referral sa Seksyon B1,

Mahahalagang termino, ng Direktoryong ito sa pahina IX.

• Maaari kang magpalit ng mga provider sa loob ng network anumang oras sa

buong taon. Kung pumupunta ka na sa isang provider sa network, hindi mo

kailangang magpatuloy sa parehong provider. Para sa ilang provider, maaari kang

mangailangan ng referral mula sa iyong PCP. Magkakaroon ng bisa ang pagpapalit

ng PCP sa unang araw ng susunod na buwan, sa kundisyon na matatanggap namin

ang iyong hiling bago ang ika-20 ng kasalukuyang buwan. Upang magpalit ng

iyong PCP, tawagan ang Customer Care. Kapag tumawag ka, siguruhing sabihin sa

Customer Care kung nagpapatingin ka sa isang espesyalista o kung nakakatanggap

ka ng iba pang nasasaklaw na serbisyo na nangangailangan ng pag-apruba ng

PCP (gaya ng mga serbisyo sa kalusugan sa tahanan at matibay na medikal na

kagamitan). Makakatulong ang Customer Care na matiyak na maipagpapatuloy

mo ang iyong pangangalaga ng espesyalista at iba pang serbisyo kapag nagpalit

ka ng iyong PCP. Titiyakin din ng Member Services kung ang ipapalit mong PCP ay

tumatanggap ng mga bagong pasyente. Babaguhin ng Member Services ang iyong

rekord sa pagiging miyembro upang ipakita ang pangalan ng bago mong PCP at

upang sabihin sa iyo kung kailan magkakaroon ng bisa ang pagpapalit mo ng PCP.

Magpapadala rin sa iyo ang Member Services ng bagong membership card kung

saan ipinapakita ang pangalan at numero ng telepono ng bago mong PCP.

• Tandaang kaanib ang mga PCP ng aming plano sa mga medikal na pangkat. Kung

nagpalit ka ng PCP, maaaring nagpalit ka rin ng medikal na pangkat. Kapag hinihiling

mo ang pagpapalit, tiyaking sabihin sa Member Services kung magpapatingin ka sa

espesyalista o kukuha ka ng iba pang nasasaklaw na serbisyong nangangailangan

ng pag-apruba ng PCP. Makakatulong ang Member Services na matiyak na

maipagpapatuloy mo ang iyong pangangalaga ng espesyalista at iba pang serbisyo

kapag nagpalit ka ng PCP.

• Nakikipagtulungan ang Blue Shield Promise Cal MediConnect Plan sa lahat ng

provider sa aming network upang maasikaso ang mga pangangailangan ng mga

taong may kapansanan. Kung naaangkop, kabilang sa listahan ng mga provider

sa network sa Direktoryong ito ang impormasyon tungkol sa mga pag-aasikasong

kanilang ibinibigay.

• Kung kailangan mong magpatingin sa isang provider at hindi ka sigurado kung

inaalok nila ang mga pag-aasikasong kailangan mo, matutulungan ka ng Blue Shield

Promise Cal MediConnect Plan. Makipag-usap sa iyong Care Navigator, para sa

tulong o tumawag sa Member Services sa 1-855-905-3825 (TTY:711) 8:00 a.m. to 8:00

p.m. seven days a week.

B5. Paano mahanap ang mga provider ng Blue Shield Promise Cal MediConnect Plan sa

inyong lugar

Parehong tinatanggap ng lahat ng provider na nakalista sa direktoryong ito ang Medicare

Kung mayroon kang mga tanong, pakitawagan ang Blue Shield Promise Cal MediConnect Plan sa

1-855-905-3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. pitong araw sa isang linggo. Libre ang tawag. Para

sa karagdagang impormasyon, bumisita sa www.blueshieldca.com/promise/calmediconnect.

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at Medi-Cal. Ang mga provider sa direktoryong ito ay nakaayos ayon sa alpabeto ayon sa

Medikal na Pangkat/IPA, pagkatapos ay ayon sa Primary Care Physician (PCPs) at nakalista

ayon sa alpabeto ayon sa apelyido sa bawat lungsod. Ang mga espesyalista ay nakalista

ayon sa uri ng espesyalidad at ayon sa lungsod. Sa pamamagitan ng paghahanap sa

lungsod kung saan ka nakatira, mahahanap mo ang mga doktor na nakalista sa iyong

lugar.

Kung mayroon kang mga tanong, pakitawagan ang Blue Shield Promise Cal MediConnect Plan sa

1-855-905-3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. pitong araw sa isang linggo. Libre ang tawag. Para

sa karagdagang impormasyon, bumisita sa www.blueshieldca.com/promise/calmediconnect.

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B6. Listahan ng mga provider sa network

Naglalaman ang direktoryong ito ng mga provider sa network ng Blue Shield Promise Cal

MediConnect Plan ng:

• Mga health care professional kabilang ang mga primary care physician, espesyalista

at mga provider para sa kalusugan ng pag-uugali at paningin

• Mga Pasilidad kabilang ang mga ospital, nursing facility, skilled nursing facility,

pasilidad ng kalusugan ng pag-iisip; at

• Mga provider ng suporta kabilang ang mga serbisyo sa mga nasa hustong gulang sa

araw, pamumuhay nang may tulong, serbisyong idinidirekta ng consumer, pagkaing

inihahatid sa tahanan at ahensya ng kalusugan sa tahanan.

Nakalista ang mga provider sa pagkakasunud-sunod na ayon sa alpabeto ayon sa

apelyido. Makikita mo rin ang pangalan ng provider at ang pahina kung saan naroon

ang karagdagang impormasyon ng pakikipag-ugnayan ng provider sa Indise sa dulo ng

Direktoryo. Nakalista rin ang mga provider sa pagkakasunud-sunod na ayon sa alpabeto

ayon sa apelyido sa Indise. Bilang karagdagan sa impormasyon ng pakikipag-ugnayan,

kabilang din sa listahan ng provider ang mga espesyalidad at kasanayan, halimbawa,

gaya ng mga wikang ginagamit o pagtatapos ng pagsasanay sa kakayahang pangkultura.

Ang pagsasanay sa kakayahang pangkultura ay karagdagang pagtuturo para sa

aming mga provider ng pangangalagang pangkalusugan na nakakatulong sa kanila

na mas mahusay na maunawaan ang iyong karanasan, mga pagpapahalaga at

mga paniniwala upang umangkop sa iyong mga pangangailangang panlipunan,

pangkultura at wika.

B7. Ang iyong Mga Karagdagang Benepisyo

Sinasaklaw ng iyong plan ang mga karagdagang benepisyo na kabilang ang paningin at

mga serbisyong acupuncture/chiropractic. Malamang na kakailanganin mong gumamit

ng mga partikular na provider para sa mga karagdagang benepisyong ito. Nakalista

ang mga provider sa direktoryong ito. Nakalista sa ibaba ang iba pang karagdagang

serbisyo. Bago ka gumawa ng isang appointment o gumamit ng mga serbisyo, tingnan

ang iyong Katibayan ng Saklaw (Evidence of Coverage) o tumawag sa Blue Shield Promise

Cal MediConnect Plan at 1-855-905-3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. pitong araw sa

isang linggo para sa mga detalye tungkol sa mga benepisyo, limitasyon at pagbubukod ng

plano. Kung hindi kasama sa iyong plan ang mga karagdagang benepisyo at pumunta ka

sa isa sa mga provider na ito, HINDI masasaklaw ang mga serbisyo sa iyo.

Kung mayroon kang mga tanong, pakitawagan ang Blue Shield Promise Cal MediConnect Plan sa

1-855-905-3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. pitong araw sa isang linggo. Libre ang tawag. Para

sa karagdagang impormasyon, bumisita sa www.blueshieldca.com/promise/calmediconnect.

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Mga Produktong Over-the Counter CVS

Ang mga ito ay mga produktong over- 1-888-628-2770 (TTY: 711)

the counter na hind saklaw ng Medicare Lunes hanggang Biyernes,

o Medi-Cal at hindi nakalista sa Tier 4 ng 9 a.m. and 5 p.m. (PT) aming Pormularyo.

Sistema ng Personal na Pagtugon sa

Emergency (PERS)

LifeStation

1-855-672-3269(TTY:711)

24 hours, 7 araw sa isang linggo

Pagiging miyembro Tivity

sa ftness

Silver Sneakers Kung miyembro ka o gustong malaman

Ang Tivity Health at SilverSneakers ay kung karapat-dapat ka:

mga nakarehistrong trademark o mga 888-423-4632, Lunes – Biyernes, 8 a.m. – 8

trademark ng Tivity Health, Inc., at/o mga p.m. EST.

subsidiary nito at/o mga kaanib na nasa USA [email protected]

at/o ibang bansa

Teladoc Maaari kang makipag-ugnay sa Teladoc sa

pamamagitan ng telepono sa 1-800-Teladoc

24/7 o sa pamamagitan ng ligtas na online

na video sawww.teladoc.com/bsc, mula 7

a.m. hanggang 9 p.m. lokal na Oras

Kung mayroon kang mga tanong, pakitawagan ang Blue Shield Promise Cal MediConnect Plan sa

1-855-905-3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. pitong araw sa isang linggo. Libre ang tawag. Para

sa karagdagang impormasyon, bumisita sa www.blueshieldca.com/promise/calmediconnect.

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C. Listahan ng network ng mga botika

Nagbibigay ang Direktoryo ng listahan ng mga botika sa network ng Blue Shield Promise

Cal MediConnect Plan. Ang mga botikang ito sa network ay mga botikang sumang-ayong

magbigay ng mga resetang gamot sa iyo bilang miyembro ng plano.

• Dapat gumamit ang mga miyembro ng Blue Shield Promise Cal MediConnect Plan ng

mga botika sa network upang makakuha ng mga resetang gamot..

○ Dapat kang gumamit ng mga botika sa network maliban sa mga sitwasyon na

emergency o maagap na pangangalaga. .

○ Kung pumunta ka sa isang botika sa labas ng network para sa mga resetang

gamot kung kailan hindi emergency, kailangan mong magbayad para sa

serbisyo. Basahin ang Blue Shield Promise Cal MediConnect Handbook ng

Miyembro para sa karagdagang impormasyon..

• Maaaring hindi nakalista ang ilang botika sa network sa Direktoryong ito.

○ May ilang parmasya sa network na maaaring nadagdag o naalis mula sa

aming plan pagkatapos ilathala ang Direktoryong ito.

Para sa napapanahong impormasyon tungkol sa mga botika sa network ng Blue

Shield Promise Cal MediConnect sa iyong lugar, pakibisita ang aming web site sa www.

blueshieldca.com/promise/calmediconnect o tumawag sa Member Services sa 1-855- 905-

3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. pitong araw sa isang linggo. Libre ang tawag.

Upang makakuha ng kumpletong paglalarawan ng iyong nasasaklaw na reseta, kabilang

ang kung paano punan ang iyong mga reseta, pakibasa ang Handbook ng Miyembro at

Listahan ng Mga Saklaw na Gamot ng Blue Shield Promise Cal MediConnect. Makikita ang

listahan ng mga Gamot sa website sa www.blueshieldca.com/promise/calmediconnect o

maaaring mag-order sa pamamagitan ng pagtawag sa Member Services sa 1-855- 905-

3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. pitong araw sa isang linggo.

C1. Paano tukuyin ang mga botika sa network ng Blue Shield Promise Cal MediConnect

Plan

Kasama ng mga tingiang botika, kabilang sa network ng mga botika ng iyong plano ang:

• Nagpapadala ang mga botikang mail-order ng mga saklaw na resetang gamot sa

mga miyembro sa pamamagitan ng koreo o mga kompanya ng shipping.

• Naghahanda ang mga botikang pag-iiniksiyon sa tahanan (home infusion pharmacy)

ng mga resetang gamot na ibinibigay sa pamamagitan ng ugat, sa kalamnan, o sa

isa pang paraan na hindi sa bibig ng isang nagsanay na provider sa iyong tahanang.

• Naglilingkod ang mga botikang pangmatagalang pangangalaga (LTC) sa mga

residente ng mga pasilidad ng pangmatagalang pangangalaga, gaya ng mga

nursing home.

• Mga botika ng Indian Health Service / Tribal / Urban Indian Health Program (I/T/U).

Hindi mo kinakailangang magpatuloy na pumunta sa iisang parmasya upang punan

ang iyong mga reseta.

Kung mayroon kang mga tanong, pakitawagan ang Blue Shield Promise Cal MediConnect Plan sa

1-855-905-3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. pitong araw sa isang linggo. Libre ang tawag. Para

sa karagdagang impormasyon, bumisita sa www.blueshieldca.com/promise/calmediconnect.

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C2. Mga pangmatagalang supply ng mga reseta

• Mga Mail-Order na Programa. Nag-aalok kami ng mail order na programang

nagbibigay-daan sa iyong makakuha ng pang-90 araw na supply ng iyong mga

resetang gamot na direkta sa iyong tahanan. Pareho ang copay ng pang- 90 araw

na supply sa pang-isang buwang supply. Hindi available ang lahat ng gamot sa

karagdagang araw ng supply na ito. Mangyaring makipag-ugnayan sa plano para

sa higit pang impormasyon.

• Mga Programa ng Pang-90 Araw na Tingiang Botika. Maaari ding mag-alok ang ilang

tingiang botika ng hanggang pang-90 araw na supply ng nasasaklaw na resetang

gamot. Pareho ang copay ng pang-90 araw na supply sa pang-isang buwang

supply. Hindi available ang lahat ng gamot sa karagdagang araw ng supply na ito.

Mangyaring makipag-ugnayan sa plano para sa higit pang impormasyon

Kung mayroon kang mga tanong, pakitawagan ang Blue Shield Promise Cal MediConnect Plan sa

1-855-905-3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. pitong araw sa isang linggo. Libre ang tawag. Para

sa karagdagang impormasyon, bumisita sa www.blueshieldca.com/promise/calmediconnect.

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Ang kabuuang network ng Blue Shield Promise Cal MediConnect Plan ay binubuo ng

sumusunod:

Kabuuang bilang ng mga PCP: 449

Kabuuang bilang ng mga espesyalista: 4327

Kabuuang bilang ng mga ospital: 18

Kabuuang bilang ng mga skilled nursing facility: 55

Kabuuang bilang ng mga nursing facility: 55

Kabuuang bilang ng mga provider ng pangmatagalang serbisyo at suporta: 1

Kabuuang bilang ng mga Tagapaglaan ng acupuncture: 659

Kabuuang bilang ng mga Pasilidad ng kalusugan ng pag-iisip: 90

Kabuuang bilang ng mga Tagapaglaan para sa kalusugan ng pag-iisip: 183

Kabuuang bilang ng mga serbisyo ng kalusugan sa tahanan: 27

Kabuuang bilang ng mga provider para sa paningin: 323

Kabuuang bilang ng mga provider para sa ngipin: 0

Kabuuang bilang ng mga tingian at malakihang botika: 441

Kabuuang bilang ng mga mail order na botika:1

Kabuuang bilang ng mga home infusion na botika: 4

KaKabuuang bilang ng mga botika para sa pangmatagalang pangangalaga: 29

Kabuuang bilang ng mga I/T/U na Botika: 4

Ang mga provider sa direktoryong ito ay nakaayos ayon sa alpabeto ayon sa medikal na

pangkat. Maaari kang makakuha ng mga serbisyo mula sa alinmang provider sa listahang

ito na kaanib sa medikal na pangkat ng iyong PCP. Para sa ilang serbisyo, maaari kang

mangailangan ng referral mula sa iyong PCP.

Kung mayroon kang mga tanong, pakitawagan ang Blue Shield Promise Cal MediConnect Plan

sa 1-855-905-3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. pitong araw sa isang linggo. Libre ang tawag.

Para sa karagdagang impormasyon, bumisita sa

www.blueshieldca.com/promise/calmediconnect.

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Page 23: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS BLUE SHIELD PROMISE HEALTH PLAN DIRECT

SPECIALISTS

Members may not self-refer to

any of the specialists listed

below. To receive covered

services from a specialist you

must receive a referral from

your primary care physician.

Cardiology

ESCONDIDO

92029

Bayat, Hamed MD

1955 Citracado Pkwy Ste 300

Escondido, CA 92029

(760) 743-0546

License: A61356

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Cardiovascular Disease

CHULA VISTA

91910

Berman, Brett MD

321 E St Ste A

Chula Vista, CA 91910

(619) 934-3260

License: A78854

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA MESA

91942

Reddy, Reddiwandla MD

5565 Grossmont Center Dr Ste

202

La Mesa, CA 91942

(619) 461-6130

License: A38098

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Kannada,

Spanish, Telugu

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Certified Nurse Practitioner

SAN MARCOS

92069

Palen, Barbara NP

150 Valpreda Rd

San Marcos, CA 92069

(760) 736-6767

License: NP3108

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 1

Page 24: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS BLUE SHIELD PROMISE HEALTH PLAN DIRECT

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

VISTA

92083

Ayele, Mahogany NP

134 Grapevine Rd

Vista, CA 92083

(844) 308-5003

License: NP19570

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Estonian,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92084

Ayele, Mahogany NP

1000 Vale Terrace Dr

Vista, CA 92084

(760) 631-5000

License: NP19570

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Estonian,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Certified Registered Nurse

Midwife

ENCINITAS

92024

Karver Christenson, Elyse

1130 2nd St

Encinitas, CA 92024

(760) 943-9994

License: NMW276

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

OCEANSIDE

92054

Alston, Vickie CRNM

2210 Mesa Dr Ste 5

Oceanside, CA 92054

(760) 757-5841

License: NM993

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 2

Page 25: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS BLUE SHIELD PROMISE HEALTH PLAN DIRECT

Dermatology

LA JOLLA

92037

Miremadi, Arjamg MD

7702 Ivanhoe Ave

La Jolla, CA 92037

(858) 456-1840

License: A31016

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Farsi,

Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Emergency Medicine

Kreshak, Allyson MD

9300 Campus Point Dr

La Jolla, CA 92037

(619) 543-6222

License: A102811

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Gastroenterology

CHULA VISTA

91910

Alayo, Erick MD

587 Third Ave

Chula Vista, CA 91910

(619) 382-3315

License: A107506

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Wiener, Gregory MD

353 Church Ave # A

Chula Vista, CA 91910

(619) 585-8883

License: A41749

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: French,

Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Wiener, Gregory MD

353 Church Ave Ste A

Chula Vista, CA 91910

(619) 585-8883

License: A41749

Credentials and/or board

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 3

Page 26: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS BLUE SHIELD PROMISE HEALTH PLAN DIRECT

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: French,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Nephrology

Soltero, Ricardo MD

340 4th Ave Ste 4

Chula Vista, CA 91910

(619) 427-1144

License: A68995

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA JOLLA

92037

Steer, Dylan MD

9834 Genesee Ave Ste 312

La Jolla, CA 92037

(858) 558-8150

License: A65604

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92103

Baranski, Joel MD

4060 4th Ave Ste 220

San Diego, CA 92103

(619) 299-2350

License: G67559

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92123

Faravardeh, Arman MD

8010 Frost St Ste 510

San Diego, CA 92123

(858) 637-4800

License: A94375

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Swedish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 4

Page 27: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS BLUE SHIELD PROMISE HEALTH PLAN DIRECT

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Obstetrics / Gynecology

NATIONAL CITY

91950

Del Rosario, Gelen MD

502 Euclid Ave Ste 300

National City, CA 91950

(619) 475-1261

License: A113471

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN MARCOS

92069

Pountney, Marlene MD

150 Valpreda Rd

San Marcos, CA 92069

(760) 736-6767

License: A93248

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Otolaryngology

SAN DIEGO

92117

Azer, Philip MD

3660 Clairemont Dr Ste 2

San Diego, CA 92117

(858) 270-8151

License: G13273

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Pathology

92103

Datnow, Brian MD

200 W Arbor Dr

San Diego, CA 92103

(619) 543-5764

License: A31095

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 5

Page 28: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS BLUE SHIELD PROMISE HEALTH PLAN DIRECT

Parast, Mana MD

200 W Arbor Dr

San Diego, CA 92103

(800) 926-8273

License: A102496

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Powell, Henry MD

200 W Arbor Dr

San Diego, CA 92103

(619) 543-5764

License: A25597

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Pediatrics

LA MESA

91942

Clay, Corrie MD

8881 Fletcher Pkwy Ste 200

La Mesa, CA 91942

(619) 464-6434

License: A91977

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN MARCOS

92069

Posadas, Emerito MD

150 Valpreda Rd

San Marcos, CA 92069

(760) 736-6767

License: A48980

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN YSIDRO

92173

Herman, Andrea MD

4050 Beyer Blvd

San Ysidro, CA 92173

(619) 428-4463

License: A72721

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 6

Page 29: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS BLUE SHIELD PROMISE HEALTH PLAN DIRECT

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

VISTA

92084

Rahimi, Nassrin MD

1000 Vale Terrace Dr

Vista, CA 92084

(760) 631-5000

License: A56214

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Farsi

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Physical Medicine /

Rehabilitation

CHULA VISTA

91910

Bullock, Andrew DO

344 F St Ste 100

Chula Vista, CA 91910

(619) 379-6579

License: 20A6842

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Fataleka, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

POWAY

92064

Bullock, Andrew DO

15644 Pomerado Rd Ste 204

Poway, CA 92064

(619) 379-6579

License: 20A6842

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Farsi,

Fataleka, Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92101

Bullock, Andrew DO

1855 1st Ave Ste 200

San Diego, CA 92101

(619) 379-6579

License: 20A6842

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Farsi,

Fataleka, Spanish

Cultural Competency: NR

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 7

Page 30: 2021 Direktoryo ng Provider at Parmasya Blue Shield

150

SAN DIEGO COUNTY MEDICAL GROUPS BLUE SHIELD PROMISE HEALTH PLAN DIRECT

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92128

Chong, Timothy MD

16466 Bernardo Center Dr Ste

San Diego, CA 92128

(858) 453-7700

License: A103353

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Physicians Assistant

CHULA VISTA

91910

Mercer, Kelly PA

760 Otay Lakes Rd

Chula Vista, CA 91910

(619) 821-2300

License: PA21625

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92104

Castillo, Patricia PA

3544 30th St

San Diego, CA 92104

(619) 515-2424

License: PA17220

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92111

Mercer, Kelly PA

5671 Balboa Ave

San Diego, CA 92111

(858) 800-2880

License: PA21625

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SANTEE

92071

Mercer, Kelly PA

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 8

Page 31: 2021 Direktoryo ng Provider at Parmasya Blue Shield

100

SAN DIEGO COUNTY MEDICAL GROUPS BLUE SHIELD PROMISE HEALTH PLAN DIRECT

10538 Mission Gorge Rd Ste

Santee, CA 92071

(619) 456-0033

License: PA21625

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Podiatrist

CHULA VISTA

91910

Longobardi, James DPM

450 4th Ave Ste 401

Chula Vista, CA 91910

(619) 425-5500

License: DPM3675

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Pulmonary Diseases

ESCONDIDO

92025

Bender, Frank MD

488 E Valley Pkwy Ste 211

Escondido, CA 92025

(760) 489-1458

License: G33933

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Rheumatology

SAN DIEGO

92108

Pazirandeh, Mahmood MD

3633 Camino Del Rio S Ste 300

San Diego, CA 92108

(619) 287-9730

License: C52328

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Russian, Spanish, Tagalog

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Surgery General

92111

Nguyen, Tri MD

7345 Linda Vista Rd Ste A

San Diego, CA 92111

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 9

Page 32: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS BLUE SHIELD PROMISE HEALTH PLAN DIRECT

(858) 277-5463

License: G79496

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Chinese,

Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Surgery Neurological

Blaskiewicz, Donald MD

3750 Convoy St Ste 301

San Diego, CA 92111

(619) 297-4481

License: A109748

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92123

Soumekh, Massoud Hertzel MD

8008 Frost St Ste 401

San Diego, CA 92123

(858) 560-8544

License: A37843

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Surgery Orthopedic

POWAY

92064

Balikian, Philip MD

15611 Pomerado Rd Ste 400

Poway, CA 92064

(858) 675-3286

License: C52136

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Armenian,

Italian, Spanish, Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Cohen, Brad MD

15611 Pomerado Rd Ste 525

Poway, CA 92064

(858) 485-0050

License: A62550

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 10

Page 33: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS BLUE SHIELD PROMISE HEALTH PLAN DIRECT

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Urology

CORONADO

92118

Roberts, James MD

230 Prospect Pl Ste 300

Coronado, CA 92118

(619) 299-0670

License: G59945

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 11

Page 34: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

AFFILIATED HOSPITALS

Above are hospitals you may

visit through this Medical

Group. For a complete listing

of hospital affiliations or to

access another hospital, refer

to page 1319. You will need to

coordinate with your PCP

and/or Medical Group. For

questions, call Blue Shield

Promise Cal MediConnect

Plan Customer Care.

PRIMARY CARE PHYSICIANS

Family Practice

CHULA VISTA

91910

Rawi, Bashir MD

256 Landis Ave Ste 202

Chula Vista, CA 91910

(619) 522-0399

Provider ID: 268578

License: A48140

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Arabic,

Farsi, Spanish, Urdu

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

91911

Elsayed, Mohammed MD

330 Oxford St Ste 106

Chula Vista, CA 91911

(619) 409-1802

Provider ID: 126786

License: A100765

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Arabic,

German, Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Rawi, Bashir MD

1323 3rd Ave

Chula Vista, CA 91911

(619) 409-6900

Provider ID: 127106

License: A48140

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Arabic,

Farsi, Spanish, Urdu

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

EL CAJON

92019

Korkis, Ebtissam MD

1530 Jamacha Rd Ste E-f

El Cajon, CA 92019

(619) 441-9200

Provider ID: 128349

License: A89767

Credentials and/or board

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 12

Page 35: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

French, Kurdish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92020

Dominguez, Dennis MD

Contract terminated as of

8/31/2021

875 El Cajon Blvd

El Cajon, CA 92020

(619) 441-3550

Provider ID: 277659

License: G43179

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ESCONDIDO

92025

Delgado, George MD

362 W Mission Ave Ste 105

Escondido, CA 92025

(760) 741-1224

Provider ID: 238500

License: G66807

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Nguyen, Ngoc MD

488 E Valley Pkwy Ste 211

Escondido, CA 92025

(760) 294-2266

Provider ID: 274685

License: A74094

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Saroki, Karen MD

362 W Mission Ave Ste 105

Escondido, CA 92025

(760) 741-1224

Provider ID: 206815

License: A105032

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Spanish

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 13

Page 36: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

NATIONAL CITY

91950

Baez, Beatrice MD

2743 Highland Ave

National City, CA 91950

(844) 200-2426

Provider ID: 238125

License: A74777

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Mckennett, Marianne MD

2835 Highland Ave Ste B

National City, CA 91950

(844) 200-2426

Provider ID: 214139

License: G57243

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Palacios, Yelennia MD

2835 Highland Ave Ste A

National City, CA 91950

(619) 474-4451

Provider ID: 268973

License: A152662

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Special Expertise: HIV/AIDS

Serpas, Shaila MD

2835 Highland Ave

National City, CA 91950

(844) 800-2426

Provider ID: 215070

License: G74728

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 14

Page 37: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Sevilla, Marianito MD

2340 E 8th St Ste D

National City, CA 91950

(619) 470-7007

Provider ID: 121762

License: A37097

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Tagalog

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Trimor-tamoria, Maria Flora

MD

2240 E Plaza Blvd Ste A

National City, CA 91950

(619) 267-5884

Provider ID: 128378

License: A55589

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish,

Tagalog

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

POWAY

92064

Cornelius, Carol MD

15611 Pomerado Rd Ste 400

Poway, CA 92064

(858) 675-3210

Provider ID: 119138

License: G53676

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: German,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Ionescu, Ludmilla MD

15611 Pomerado Rd Fl 3

Poway, CA 92064

(858) 675-3210

Provider ID: 270004

License: C130451

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Russian

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Maletz, Louis MD

15611 Pomerado Rd Ste 400

Poway, CA 92064

(858) 675-3100

Provider ID: 119131

License: G50801

Credentials and/or board

certification: No

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 15

Page 38: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: German,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Meram, Susan MD

15611 Pomerado Rd Ste 400

Poway, CA 92064

(858) 675-3100

Provider ID: 119136

License: A53727

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Mir, Yusra MD

15611 Pomerado Rd Ste 400

Poway, CA 92064

(858) 675-3100

Provider ID: 119139

License: A101298

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Hindi,

Spanish, Urdu

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Putnam, Richard MD

15611 Pomerado Rd Ste 300

Poway, CA 92064

(858) 675-3100

Provider ID: 270285

License: G50068

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

RAMONA

92065

Blando, Ellen MD

211 13th St

Ramona, CA 92065

(760) 789-5160

Provider ID: 119142

License: A65631

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 16

Page 39: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

present. Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: German,

Dassoff, David MD Spanish

211 13th St Cultural Competency: NR

Ramona, CA 92065 Accessibility: B; Members

(760) 789-5160 should call the provider’s

Provider ID: 119125 office to discuss their

License: G137536 accessibility needs when there

Credentials and/or board is limited access or when

certification: No accessibility indicators are not

Accepting New Members: Yes present.

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish Miller, Jerry MD

Cultural Competency: NR 211 13th St

Accessibility: B; Members Ramona, CA 92065

should call the provider’s (760) 789-5160

office to discuss their Provider ID: 119127

accessibility needs when there License: A119340

is limited access or when Credentials and/or board

accessibility indicators are not certification: No

present. Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Kasch, Janine DO Other Language: Spanish

211 13th St Cultural Competency: NR

Ramona, CA 92065 Accessibility: B; Members

(760) 789-5160 should call the provider’s

Provider ID: 271735 office to discuss their

License: 20A5832 accessibility needs when there

Credentials and/or board is limited access or when

certification: No accessibility indicators are not

Accepting New Members: Yes present.

SAN DIEGO

92102

Rawi, Bashir MD

955 Gateway Center Way Ste

105

San Diego, CA 92102

(619) 264-1934

Provider ID: 268579

License: A48140

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Farsi, Spanish, Urdu

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92105

Recalde, Francisco MD

3811 El Cajon Blvd

San Diego, CA 92105

(619) 284-5622

Provider ID: 128320

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 17

Page 40: 2021 Direktoryo ng Provider at Parmasya Blue Shield

106

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

License: C41872

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92108

Delgado, George MD

5030 Camino De La Siesta Ste

San Diego, CA 92108

(619) 692-4401

Provider ID: 238499

License: G66807

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Farsi,

Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Saroki, Karen MD

5030 Camino De La Siesta Ste

106

San Diego, CA 92108

(619) 692-4401

Provider ID: 129342

License: A105032

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Farsi,

Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92111

Ahn, Edward MD

Contract terminated as of

8/31/2021

7750 Dagget St Ste 108

San Diego, CA 92111

(858) 571-1004

Provider ID: 271642

License: A38304

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Korean

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92115

Le, Tram MD

5507 El Cajon Blvd # L

San Diego, CA 92115

(619) 286-2789

Provider ID: 129203

License: A105829

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 18

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

PTA: Yes present. certification: No

Other Language: Spanish,

Vietnamese

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92129

Blando, Ellen MD

9878 Carmel Mountain Rd Ste

B

San Diego, CA 92129

(858) 312-1440

Provider ID: 270143

License: A65631

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

92131

Nuqui, Josie MD

9855 Erma Rd Ste 105

San Diego, CA 92131

(844) 200-2426

Provider ID: 215006

License: A71544

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92154

Villa, Maria MD

655 Saturn Blvd Ste J

San Diego, CA 92154

(619) 575-4442

Provider ID: 122410

License: A86224

Credentials and/or board

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish,

Tagalog

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

VISTA

92083

Carrio, Kelsey MD

134 Grapevine Rd

Vista, CA 92083

(760) 631-5000

Provider ID: 273483

License: A158602

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 19

Page 42: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

General Practice

CHULA VISTA

91911

Toledo, Abel MD

330 Oxford St Ste 110

Chula Vista, CA 91911

(619) 427-3118

Provider ID: 121721

License: A67360

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Italian,

Portuguese, Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ESCONDIDO

92025

Lopez, Irma MD

1035 E Grand Ave Ste 101

Escondido, CA 92025

(760) 480-4747

Provider ID: 207280

License: G57022

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Watson, Thomas MD

301 E Washington Ave Ste B

Escondido, CA 92025

(760) 480-9051

Provider ID: 121566

License: A52193

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Watson, Thomas MD

303 S Juniper St

Escondido, CA 92025

(760) 480-9051

Provider ID: 224918

License: A52193

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 20

Page 43: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

(619) 445-6200 PTA: No92115

Dwabe, Kefah MD

4863 El Cajon Blvd # A

San Diego, CA 92115

(619) 286-9000

Provider ID: 121673

License: A94193

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Arabic,

Burmese, Cambodian, Thai

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Internal Medicine

ALPINE

91901

Kellawon, Joyce MD

Contract terminated as of

7/31/2021

1620 Alpine Blvd

Alpine, CA 91901

Provider ID: 245003

License: C54522

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Korean, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

CAMPO

91906

Kellawon, Joyce MD

Contract terminated as of

7/31/2021

1388 Buckman Springs Rd

Campo, CA 91906

(619) 445-6200

Provider ID: 245004

License: C54522

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

Other Language: Arabic,

Korean, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

CHULA VISTA

91910

Espinosa-melendez, Enrique

MD

480 4th Ave Ste 507

Chula Vista, CA 91910

(619) 477-7779

Provider ID: 121742

License: C42745

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: French,

Portuguese, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 21

Page 44: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

is limited access or when

accessibility indicators are not

present.

Flores, Rocio MD

296 H St Ste 201

Chula Vista, CA 91910

(619) 271-5551

Provider ID: 258897

License: A69424

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Fadhil, Ali MD

340 Fourth Ave Ste 9

Chula Vista, CA 91910

(619) 426-9731

Provider ID: 268952

License: A145663

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

91911

De La Rosa, Renato MD

754 Medical Center Ct Ste 103

Chula Vista, CA 91911

(619) 397-5001

Provider ID: 121769

License: A65330

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

EL CAJON

92019

Reddy, Arjun MD

5442 Sycuan Rd

El Cajon, CA 92019

(619) 445-0707

Provider ID: 129312

License: A61204

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92020

Elias, Ramiz MD

231 W Main St

El Cajon, CA 92020

(858) 384-6857

Provider ID: 272654

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 22

Page 45: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

License: A99956 office to discuss their

Credentials and/or board accessibility needs when there

certification: No is limited access or when

Accepting New Members: Yes accessibility indicators are not

Hours: M-SA 9AM-5PM present.

PTA: No

Other Language: Arabic, 92021 Farsi, Spanish

Cultural Competency: NR Toulouie, Elahe MD

Accessibility: B; Members Contract terminated as of

should call the provider’s 8/31/2021

office to discuss their 1580 N 2nd St

accessibility needs when there El Cajon, CA 92021

is limited access or when (619) 447-2425

accessibility indicators are not Provider ID: 269054

present. License: A73141

Credentials and/or board

certification: No

Jahanpanah, Fereshteh MD Accepting New Members: No

343 E Main St Ste 101 Hours: M-SA 9AM-5PM

El Cajon, CA 92020 PTA: No

(619) 447-6001 Other Language: Armenian,

Provider ID: 252339 Farsi, German

License: G65104 Cultural Competency: NR

Credentials and/or board Accessibility: B; Members

certification: No should call the provider’s

Accepting New Members: Yes office to discuss their

Hours: M-SA 9AM-5PM accessibility needs when there

PTA: No is limited access or when

Other Language: Arabic, accessibility indicators are not

Faroese, Farsi, Spanish present.

Cultural Competency: NR

Accessibility: B; Members ESCONDIDOshould call the provider’s

92025

Mashayekhi, Pegah DO

488 E Valley Pkwy Ste 211

Escondido, CA 92025

(760) 294-2266

Provider ID: 269119

License: 20A12987

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Shapiro, Mark MD

Contract terminated as of

8/31/2021

631 E Grand Ave

Escondido, CA 92025

(760) 294-1660

Provider ID: 275625

License: G65280

Credentials and/or board

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 23

Page 46: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Swahili

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA MESA

91942

Prabaker, Venugopal MD

7339 El Cajon Blvd Ste I

La Mesa, CA 91942

(619) 698-0606

Provider ID: 123698

License: A42653

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Arabic,

Chinese, Polish, Russian,

Spanish, Tagalog, Tamil, Thai

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Toulouie, Elahe MD

Contract terminated as of

8/31/2021

5358 Jackson Dr # 1

La Mesa, CA 91942

(619) 993-8996

Provider ID: 269053

License: A73141

Credentials and/or board

certification: Yes

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Armenian,

Farsi, German

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

NATIONAL CITY

91950

Altavas, Valerie MD

655 Euclid Ave Ste 209

National City, CA 91950

(619) 470-7000

Provider ID: 121740

License: C52243

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish,

Tagalog

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Sacamay, Elena Maria MD

655 Euclid Ave Ste 209

National City, CA 91950

(619) 470-7000

Provider ID: 121747

License: A63422

Credentials and/or board

certification: No

Accepting New Members: Yes

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 24

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish,

Tagalog, Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

POWAY

92064

Carty, David MD

15611 Pomerado Rd Ste 400

Poway, CA 92064

(858) 675-3293

Provider ID: 119124

License: A41501

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Dure-smith, Belinda MD

15611 Pomerado Rd Ste 400

Poway, CA 92064

(858) 675-3293

Provider ID: 119129

License: A52257

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Mamaril, Dennis MD

15611 Pomerado Rd Ste 400

Poway, CA 92064

(858) 675-3293

Provider ID: 119126

License: A90180

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Presant, Larry MD

15611 Pomerado Rd Ste 400

Poway, CA 92064

(858) 675-3100

Provider ID: 119128

License: G42579

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 25

Page 48: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

SAN DIEGO

92101

Lichtenstein, Bernard MD

250 Market St

San Diego, CA 92101

(619) 236-0111

Provider ID: 271039

License: A37396

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Other Language: German,

Hebrew, Polish, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Quinonez, Jose MD

250 Market St

San Diego, CA 92101

(619) 239-9675

Provider ID: 121499

License: A44257

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92102

Kellawon, Joyce MD

Contract terminated as of

7/31/2021

316 25th St

San Diego, CA 92102

(619) 445-6200

Provider ID: 245005

License: C54522

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Korean, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Nanduri, Ramachander MD

995 Gateway Center Way Ste

202

San Diego, CA 92102

(619) 264-3107

Provider ID: 127124

License: C50916

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Hindi,

Kannada, Spanish, Tamil,

Telugu

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92111

Nguyen, Tri MD

7345 Linda Vista Rd Ste A

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 26

Page 49: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

San Diego, CA 92111

(858) 277-5463

Provider ID: 121932

License: G79496

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Chinese,

Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92115

Kellawon, Joyce MD

Contract terminated as of

7/31/2021

4690 El Cajon Blvd

San Diego, CA 92115

(619) 445-6200

Provider ID: 245006

License: C54522

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Korean, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Le, Charles MD

4440 Euclid Ave Ste A

San Diego, CA 92115

(619) 521-6812

Provider ID: 127992

License: A124891

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Nguyen, Tri MD

4206 44th St

San Diego, CA 92115

(361) 962-4943

Provider ID: 270970

License: G79496

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Chinese,

Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Nguyen, Tue MD

4551 El Cajon Blvd

San Diego, CA 92115

(619) 280-7185

Provider ID: 270714

License: A49831

Credentials and/or board

certification: No

Accepting New Members: No

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 27

Page 50: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Vietnamese

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Truong, Tu MD

5069 El Cajon Blvd

San Diego, CA 92115

(619) 583-8705

Provider ID: 129346

License: A50756

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Cambodian,

Spanish, Vietnamese

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Vo, Sony MD

4551 El Cajon Blvd

San Diego, CA 92115

(619) 280-7185

Provider ID: 128372

License: A49788

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92123

Elias, Ramiz MD

7695 Cardinal Ct Ste 375

San Diego, CA 92123

(858) 384-7072

Provider ID: 129397

License: A99956

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Farsi, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Shapiro, Mark MD

Contract terminated as of

8/31/2021

9610 Granite Ridge Dr Ste B

San Diego, CA 92123

(858) 810-8000

Provider ID: 270972

License: G65280

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Swahili

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 28

Page 51: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

is limited access or when

accessibility indicators are not

present.

92126

Fabella, Gabriel MD

10737 Camino Ruiz Ste 115

San Diego, CA 92126

(858) 695-1262

Provider ID: 121666

License: A48087

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Japanese,

Spanish, Tagalog

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92139

Daramola, Iyabo MD

2401 Reo Dr

San Diego, CA 92139

(619) 479-6767

Provider ID: 247461

License: A63633

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish,

Tagalog

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92154

De Carvalho, Carlos MD

2939 Beyer Blvd

San Diego, CA 92154

(619) 423-0343

Provider ID: 259918

License: A38504

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Portuguese,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SPECIALISTS

Members may not self-refer to

any of the specialists listed

below. To receive covered

services from a specialist you

must receive a referral from

your primary care physician.

Allergy Immunology

LA MESA

91942

Reddy, Sumana MD

8860 Center Dr Ste 320

La Mesa, CA 91942

(619) 377-6565

Provider ID: 82087

License: C52581

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 29

Page 52: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Other Language: Hindi,

Spanish, Telugu

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92120

Reddy, Sumana MD

6699 Alvarado Rd Ste 2301

San Diego, CA 92120

(619) 588-4074

Provider ID: 65617

License: C52581

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Hindi,

Spanish, Telugu

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SANTEE

92071

Reddy, Sumana MD

9456 Cuyamaca St Ste 102

Santee, CA 92071

(619) 377-6565

Provider ID: 69230

License: C52581

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Hindi,

Spanish, Telugu

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

VISTA

92083

Ziering, Robert MD

2067 W Vista Way Ste 140

Vista, CA 92083

(760) 941-4444

Provider ID: 269520

License: A30813

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Anesthesiology Critical Care

Medicine

CHULA VISTA

91914

Macchio, Gregory MD

2452 Fenton St Ste C101

Chula Vista, CA 91914

(619) 600-5309

Provider ID: 268814

License: G88576

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 30

Page 53: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Macchio, Gregory MD

2452 Fenton St Ste C203

Chula Vista, CA 91914

(619) 600-5309

Provider ID: 268815

License: G88576

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Anesthesiology Pain

Management

CARLSBAD

92011

Truong, Ngoc DO

6010 Hidden Valley Rd Ste 110

Carlsbad, CA 92011

(760) 607-5350

Provider ID: 277809

License: 20A13556

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Special Expertise: HIV/AIDS

CHULA VISTA

91910

Fisher, Casey MD

374 H St Ste 103

Chula Vista, CA 91910

(619) 625-1144

Provider ID: 204415

License: A118592

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

91914

Navarro, Rosa MD

2452 Fenton St # C101

Chula Vista, CA 91914

(619) 600-5309

Provider ID: 268792

License: C53858

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 31

Page 54: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Navarro, Rosa MD

2452 Fenton St Ste C203

Chula Vista, CA 91914

(619) 600-5309

Provider ID: 268793

License: C53858

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Verdolin, Michael MD

2452 Fenton St Ste 205

Chula Vista, CA 91914

(619) 625-1144

Provider ID: 257923

License: A92149

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Italian,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ENCINITAS

92024

Fisher, Casey MD

326 Encinitas Blvd Ste 100

Encinitas, CA 92024

(619) 825-8511

Provider ID: 269185

License: A118592

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ESCONDIDO

92029

Cohen, Zachary MD

2185 Citracado Pkwy

Escondido, CA 92029

(442) 281-5000

Provider ID: 268178

License: A146733

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA MESA

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 32

Page 55: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

91942

Fisher, Casey MD

7051 Alvarado Rd Ste 101

La Mesa, CA 91942

(619) 625-1144

Provider ID: 204414

License: A118592

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Verdolin, Michael MD

7051 Alvarado Rd Ste 101

La Mesa, CA 91942

(619) 625-1144

Provider ID: 203328

License: A92149

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Italian,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

NATIONAL CITY

91950

Wynn, Brenton MD

502 Euclid Ave Ste 200

National City, CA 91950

(619) 434-4019

Provider ID: 268987

License: A73257

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

OCEANSIDE

92056

Fisher, Casey MD

3142 Vista Way Ste 207

Oceanside, CA 92056

(760) 610-0522

Provider ID: 269184

License: A118592

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

POWAY

92064

Cohen, Zachary MD

15611 Pomerado Rd Ste 505

Poway, CA 92064

(760) 631-3000

Provider ID: 268179

License: A146733

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 33

Page 56: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Fisher, Casey MD

15725 Pomerado Rd Ste 218

Poway, CA 92064

(619) 825-8511

Provider ID: 204416

License: A118592

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Verdolin, Michael MD

15725 Pomerado Rd Ste 218

Poway, CA 92064

(619) 825-8511

Provider ID: 203330

License: A92149

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Italian,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Anesthesiology

ESCONDIDO

92025

Khatibi, Nikan DO

430 N Cedar St Ste D

Escondido, CA 92025

(888) 873-6220

Provider ID: 118688

License: 20A11914

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Khatibi, Nikan DO

160 N Date St

Escondido, CA 92025

(888) 873-6220

Provider ID: 239611

License: 20A11914

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Spanish

Cultural Competency: NR

Accessibility: B; Members

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 34

Page 57: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Audiologist

Herrera, Charity MA

330 W Felicita Ave Ste A4

Escondido, CA 92025

(760) 489-1323

Provider ID: 269239

License: AU2110

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92123

Herrera, Charity MA

9340 Clairemont Mesa Blvd Ste

D

San Diego, CA 92123

(858) 278-9911

Provider ID: 269240

License: AU2110

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Cardiac Electrophysiology

OCEANSIDE

92056

Bui, Hanh MD

3909 Waring Rd Ste A

Oceanside, CA 92056

(760) 630-2550

Provider ID: 269408

License: A79185

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Chinese,

Spanish, Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Cardiology

CHULA VISTA

91910

Berman, Brett MD

321 E St Ste A

Chula Vista, CA 91910

(619) 934-3260

Provider ID: 268466

License: A78854

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 35

Page 58: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Kafri, Hassan MD

429 Broadway

Chula Vista, CA 91910

(619) 434-0204

Provider ID: 265196

License: A96002

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Farsi, German, Russian,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Ponce, Sonia MD

450 Fourth Ave Ste 215

Chula Vista, CA 91910

(619) 434-0204

Provider ID: 268702 should call the provider’s

License: A145008 office to discuss their

Credentials and/or board accessibility needs when there

certification: No is limited access or when

Accepting New Members: Yes accessibility indicators are not

Hours: M-SA 9AM-5PM

PTA: No

present.

Other Language: Spanish

Cultural Competency: NR Mohamedali, Burhan MD

Accessibility: B; Members 765 Medical Center Ct Ste 211

should call the provider’s Chula Vista, CA 91911

office to discuss their (619) 616-2100

accessibility needs when there Provider ID: 245576

is limited access or when License: A125669

accessibility indicators are not Credentials and/or board

present. certification: No

Accepting New Members: Yes

91911 Hours: M-SA 9AM-5PM

PTA: No

Moussavian, Mehran DO Other Language: Spanish,

765 Medical Center Ct Ste 211 Swahili

Chula Vista, CA 91911 Cultural Competency: NR

(619) 616-2100 Accessibility: B; Members

Provider ID: 242263 should call the provider’s

License: 20A7241 office to discuss their

Credentials and/or board accessibility needs when there

certification: No is limited access or when

Accepting New Members: Yes accessibility indicators are not

Hours: M-SA 9AM-5PM present.

PTA: No

Other Language: Farsi,

Spanish Naghi, Jesse MD

Cultural Competency: NR 752 Medical Center Ct Ste 207

Accessibility: B; Members Chula Vista, CA 91911

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 36

Page 59: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

(619) 867-0557 Accessibility: B; Members (619) 597-1341

Provider ID: 247625 should call the provider’s Provider ID: 268950

License: A110094 office to discuss their License: A70917

Credentials and/or board accessibility needs when there Credentials and/or board

certification: No is limited access or when certification: No

Accepting New Members: Yes accessibility indicators are not Accepting New Members: Yes

Hours: M-SA 9AM-5PM present. Hours: M-SA 9AM-5PM

PTA: No PTA: No

Other Language: Arabic, Other Language: Bulgarian,

Bulgarian, Russian, Spanish, Rutledge, Michael MD Malayalam, Russian, Spanish

Tagalog 751 Medical Center Ct Cultural Competency: NR

Cultural Competency: NR Chula Vista, CA 91911 Accessibility: B; Members

Accessibility: B; Members (619) 502-5851 should call the provider’s

should call the provider’s Provider ID: 268763 office to discuss their

office to discuss their License: C166106 accessibility needs when there

accessibility needs when there Credentials and/or board is limited access or when

is limited access or when certification: No accessibility indicators are not

accessibility indicators are not Accepting New Members: Yes present.

present. Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish Shetabi, Kambiz MD

Parikh, Milind DO Cultural Competency: NR 765 Medical Center Ct Ste 211

765 Medical Center Ct Ste 211 Accessibility: B; Members Chula Vista, CA 91911

Chula Vista, CA 91911 should call the provider’s (619) 616-2100

(619) 616-2100 office to discuss their Provider ID: 268772

Provider ID: 268745 accessibility needs when there License: A126187

License: 20A13745 is limited access or when Credentials and/or board

Credentials and/or board accessibility indicators are not certification: No

certification: Yes present. Accepting New Members: Yes

Accepting New Members: Yes Hours: M-SA 9AM-5PM

Hours: M-SA 9AM-5PM PTA: No

PTA: No Sherev, Dimitri MD Other Language: Spanish

Other Language: Spanish 752 Medical Center Ct Ste 207 Cultural Competency: NR

Cultural Competency: NR Chula Vista, CA 91911 Accessibility: B; Members

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 37

Page 60: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

91914

Cepin, Daniel MD

890 Eastlake Pkwy Ste 205

Chula Vista, CA 91914

(619) 482-0300

Provider ID: 268781

License: G52521

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

EL CAJON

92020

Kafri, Hassan MD

328 Highland Ave Ste 200

El Cajon, CA 92020

(619) 930-9404

Provider ID: 209019

License: A96002

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Farsi, German, Russian,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Ponce, Sonia MD

328 Highland Ave Ste 200

El Cajon, CA 92020

(619) 930-9404

Provider ID: 268703

License: A145008

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92021

Sharf, Albert MD

1240 Broadway Ste 210

El Cajon, CA 92021

(619) 470-7700

Provider ID: 269167

License: G72122

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ESCONDIDO

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 38

Page 61: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

92029

Bayat, Hamed MD

1955 Citracado Pkwy Ste 300

Escondido, CA 92029

(760) 743-0546

Provider ID: 53687

License: A61356

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Gilbert, Christopher MD

1955 Citracado Pkwy Ste 300

Escondido, CA 92029

(760) 743-0546

Provider ID: 63549

License: A35403

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Gorwit, Jeffrey MD

1955 Citracado Pkwy Ste 300

Escondido, CA 92029

(760) 743-0546

Provider ID: 63540

License: G25365

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Sawhney, Navinder MD

1955 Citracado Pkwy Ste 300

Escondido, CA 92029

(760) 743-0546

Provider ID: 112701

License: A86378

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Serry, Rod MD

1955 Citracado Pkwy Ste 300

Escondido, CA 92029

(760) 743-0546

Provider ID: 54469

License: A76061

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Portuguese, Spanish

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 39

Page 62: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA MESA

91942

Naghi, Jesse MD

8851 Center Dr Ste 304

La Mesa, CA 91942

(619) 867-0557

Provider ID: 119543

License: A110094

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Bulgarian, Russian, Spanish,

Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Sherev, Dimitri MD

8851 Center Dr Ste 304

La Mesa, CA 91942

(619) 867-0557

Provider ID: 65688

License: A70917

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Bulgarian,

Malayalam, Russian, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Yellen, Laurence MD

8851 Center Dr Ste 405

La Mesa, CA 91942

(619) 582-2404

Provider ID: 269173

License: G15453

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

NATIONAL CITY

91950

Camacho, Benjamin MD

1615 Sweetwater Rd

National City, CA 91950

(619) 474-2233

Provider ID: 269129

License: A52660

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Tagalog

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 40

Page 63: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

present. Accepting New Members: Yes accessibility indicators are not

Hours: M-SA 9AM-5PM present.

PTA: Yes

Dubey, Rajesh MD Other Language: Bulgarian,

610 Euclid Ave Ste 302 Russian, Spanish Nanavati, Vimal MD

National City, CA 91950 Cultural Competency: NR 2345 E 8th St Ste 111

(209) 521-9661 Accessibility: B, W; Members National City, CA 91950

Provider ID: 269343 should call the provider’s (619) 585-0476

License: A83527 office to discuss their Provider ID: 269553

Credentials and/or board accessibility needs when there License: G83522

certification: No is limited access or when Credentials and/or board

Accepting New Members: Yes accessibility indicators are not certification: No

Hours: M-SA 9AM-5PM present. Accepting New Members: Yes

PTA: No Hours: M-SA 9AM-5PM

Other Language: Bengali, PTA: No

Hindi, Spanish Fernandez, Genaro MD Cultural Competency: NR

Cultural Competency: NR 610 Euclid Ave Ste 201 Accessibility: B; Members

Accessibility: B; Members National City, CA 91950 should call the provider’s

should call the provider’s (619) 267-8181 office to discuss their

office to discuss their Provider ID: 268889 accessibility needs when there

accessibility needs when there License: A122302 is limited access or when

is limited access or when Credentials and/or board accessibility indicators are not

accessibility indicators are not certification: No present.

present. Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No Oviedo-linares, Raul MD

Fernandez, Genaro MD Other Language: French, 502 Euclid Ave Ste 104

610 Euclid Ave Ste 201 Italian, Spanish National City, CA 91950

National City, CA 91950 Cultural Competency: NR (619) 434-4288

(619) 267-8181 Accessibility: B; Members Provider ID: 269140

Provider ID: 121669 should call the provider’s License: A76050

License: A45754 office to discuss their Credentials and/or board

Credentials and/or board accessibility needs when there certification: No

certification: No is limited access or when Accepting New Members: Yes

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 41

Page 64: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Polish,

Spanish, Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Pandhi, Jay MD

655 Euclid Ave Ste 208

National City, CA 91950

(619) 512-1915

Provider ID: 269087

License: C56015

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Rough, Steven MD

1615 Sweetwater Rd Ste D

National City, CA 91950

(619) 474-2233

Provider ID: 269349

License: A124001

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Rough, Steven MD

502 Euclid Ave Ste 104

National City, CA 91950

(619) 434-4288

Provider ID: 269350

License: A124001

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

POWAY

92064

Bayat, Hamed MD

15611 Pomerado Rd Ste 400

Poway, CA 92064

(858) 592-2696

Provider ID: 269450

License: A61356

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 42

Page 65: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Balouch, Maryam MD

15615 Pomerado Rd

Poway, CA 92064

(760) 743-0546

Provider ID: 269384

License: A121988

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Mulvihill, Daniel MD

15611 Pomerado Rd Ste 580

Poway, CA 92064

(858) 592-2696

Provider ID: 54301

License: G55384

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Serry, Rod MD

15611 Pomerado Rd Ste 400

Poway, CA 92064

(858) 675-3100

Provider ID: 269471

License: A76061

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Portuguese, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Vanichsarn, Christopher MD

15611 Pomerado Rd Ste 400

Poway, CA 92064

(858) 592-2696

Provider ID: 274775

License: A129210

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92111

Nguyen, Tri MD

7345 Linda Vista Rd Ste A

San Diego, CA 92111

(858) 277-5463

Provider ID: 121932

License: G79496

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: Yes

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 43

Page 66: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Other Language: Chinese,

Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92114

Moussavian, Mehran DO

292 Euclid Ave Ste 210

San Diego, CA 92114

(619) 616-2100

Provider ID: 242264

License: 20A7241

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

Mohamedali, Burhan MD PTA: No

292 Euclid Ave Ste 210

San Diego, CA 92114

(619) 616-2100

Provider ID: 245577

License: A125669

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

Credentials and/or board

certification: No

accessibility needs when there

is limited access or when

Accepting New Members: Yes accessibility indicators are not

Hours: M-SA 9AM-5PM

PTA: No

present.

Other Language: Spanish,

Swahili

Cultural Competency: NR

Nguyen, Tri MD

4206 44th St

Accessibility: B; Members

should call the provider’s

office to discuss their

San Diego, CA 92115

(361) 962-4943

Provider ID: 270970

accessibility needs when there License: G79496

is limited access or when

accessibility indicators are not

Credentials and/or board

certification: No

present. Accepting New Members: No

Hours: M-SA 9AM-5PM

92115

Gollapudi, Raghava MD

6402 El Cajon Blvd # 102

San Diego, CA 92115

(858) 499-1900

Provider ID: 270061

PTA: Yes

Other Language: Chinese,

Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

License: A73392

Credentials and/or board

certification: No

accessibility needs when there

is limited access or when

accessibility indicators are not

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 44

Page 67: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

present.

Sharf, Albert MD

4444 El Cajon Blvd Ste 2

San Diego, CA 92115

(619) 470-7700

Provider ID: 246500

License: G72122

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92123

Gollapudi, Raghava MD

7901 Frost St

San Diego, CA 92123

(858) 499-1900

Provider ID: 270060

License: A73392

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN MARCOS

92078

Moussavian, Mehran DO

955 Boardwalk Ste 100

San Marcos, CA 92078

(619) 616-2100

Provider ID: 242265

License: 20A7241

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Mohamedali, Burhan MD

955 Boardwalk Ste 100

San Marcos, CA 92078

(760) 798-8855

Provider ID: 245578

License: A125669

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Swahili

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

VISTA

92083

Kabra, Ashish MD

2067 W Vista Way Ste 225

Vista, CA 92083

(760) 630-2550

Provider ID: 271714

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 45

Page 68: 2021 Direktoryo ng Provider at Parmasya Blue Shield

115

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

License: A122620

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Cardiovascular Disease

LA MESA

91942

Boghairi, Anoushiravan MD

5565 Grossmont Center Dr Ste

La Mesa, CA 91942

(619) 698-6667

Provider ID: 269055

License: A33832

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Persian

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Kotha, Purushotham MD

8860 Center Dr Ste 400

La Mesa, CA 91942

(619) 229-1995

Provider ID: 32053

License: A41538

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Hindi,

Spanish, Telugu

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

POWAY

92064

Zakov, Kamen MD

15611 Pomerado Rd Ste 400

Poway, CA 92064

(858) 592-2696

Provider ID: 122539

License: G31706

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Certified Acupuncturist

ALPINE

91901

Vuong, Long LAC

1620 Alpine Blvd Ste 110

Alpine, CA 91901

(619) 320-3343

Provider ID: 245211

License: AC17785

Credentials and/or board

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 46

Page 69: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Chinese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

NATIONAL CITY

91950

Seitz, Gretchen LAC

2835 Highland Ave Ste B

National City, CA 91950

(844) 200-2426

Provider ID: 246472

License: AC8597

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Seitz, Gretchen LAC

2743 Highland Ave

National City, CA 91950

(844) 200-2426

Provider ID: 246475

License: AC8597

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92103

Seitz, Gretchen LAC

3320 2nd Ave

San Diego, CA 92103

(619) 302-6846

Provider ID: 246470

License: AC8597

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92126

Seitz, Gretchen LAC

10737 Camino Ruiz Ste 235

San Diego, CA 92126

(844) 200-2426

Provider ID: 246471

License: AC8597

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 47

Page 70: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

accessibility needs when there Provider ID: 246473 Accessibility: B; Members

is limited access or when License: AC8597 should call the provider’s

accessibility indicators are not Credentials and/or board office to discuss their

present. certification: No accessibility needs when there

Accepting New Members: Yes is limited access or when

Hours: M-SA 9AM-5PM accessibility indicators are not92129 PTA: No present.

Seitz, Gretchen LAC Other Language: Spanish

9995 Carmel Mountain Rd # Cultural Competency: NR

B10-b11 Accessibility: B; Members

San Diego, CA 92129 should call the provider’s

(844) 200-2426 office to discuss their

CAMPO

91906

Nace, Michael NPProvider ID: 246474 accessibility needs when there 1388 Buckman Springs RdLicense: AC8597 is limited access or when Campo, CA 91906Credentials and/or board accessibility indicators are not (619) 445-6200certification: No present. Provider ID: 240032Accepting New Members: Yes License: NP11492Hours: M-SA 9AM-5PM Credentials and/or boardPTA: No certification: NoOther Language: Spanish Accepting New Members: YesCultural Competency: NR Hours: M-SA 9AM-5PMAccessibility: B; Members PTA: Noshould call the provider’s

Nace, Michael NP Cultural Competency: NR

Certified Nurse Practitioner

ALPINE

91901

office to discuss their 1620 Alpine Blvd Ste 110 Accessibility: B; Members accessibility needs when there Alpine, CA 91901 should call the provider’sis limited access or when (619) 445-6200 office to discuss theiraccessibility indicators are not Provider ID: 240033 accessibility needs when therepresent. License: NP11492 is limited access or when

Credentials and/or board accessibility indicators are not92131

certification: No present.

Accepting New Members: YesSeitz, Gretchen LAC Hours: M-SA 9AM-5PM9855 Erma Rd Ste 105 CARLSBAD PTA: NoSan Diego, CA 92131 Cultural Competency: NR(844) 200-2426

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 48

Page 71: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

92011

Bierman, Andrew NP

6010 Hidden Valley Rd Ste 200

Carlsbad, CA 92011

(760) 631-3000

Provider ID: 247291

License: NP95011909

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Bishop, Leslie NP

6010 Hidden Valley Rd Ste 200

Carlsbad, CA 92011

(760) 631-3000

Provider ID: 243217

License: NP95010047

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Binavi, Hownaz NP

6010 Hidden Valley Rd Ste 120

Carlsbad, CA 92011

(760) 884-5990

Provider ID: 265369

License: NP95010956

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Kurdish,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Hooper, Bonnie NP

6010 Hidden Valley Rd Ste 120

Carlsbad, CA 92011

(760) 884-5990

Provider ID: 275252

License: NP6495

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

CHULA VISTA

91910

Carapia, Fabiola NP

340 4th Ave Ste 4

Chula Vista, CA 91910

(619) 427-1144

Provider ID: 268543

License: RN603937

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 49

Page 72: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Accessibility: B; Members (619) 421-3361 is limited access or when

should call the provider’s Provider ID: 268746 accessibility indicators are not

office to discuss their License: NP95008069 present.

accessibility needs when there Credentials and/or board

is limited access or when certification: No

accessibility indicators are not Accepting New Members: Yes De Roldan, Sandra NP

present. Hours: M-SA 9AM-5PM 752 Medical Center Ct Ste 210

PTA: No Chula Vista, CA 91911

Cultural Competency: NR (619) 656-0206

Carapia, Fabiola NP Accessibility: B; Members Provider ID: 269290

340 4th Ave Ste 4 should call the provider’s License: NP22506

Chula Vista, CA 91910 office to discuss their Credentials and/or board

(619) 427-1144 accessibility needs when there certification: No

Provider ID: 268543 is limited access or when Accepting New Members: Yes

License: NP20855 accessibility indicators are not Hours: M-SA 9AM-5PM

Credentials and/or board present. PTA: No

certification: No Cultural Competency: NR

Accepting New Members: Yes Accessibility: B; Members

Hours: M-SA 9AM-5PM Buenrostro, Christina NP should call the provider’s

PTA: Yes 765 Medical Center Ct Ste 209 office to discuss their

Cultural Competency: NR Chula Vista, CA 91911 accessibility needs when there

Accessibility: B; Members (619) 427-8892 is limited access or when

should call the provider’s Provider ID: 269282 accessibility indicators are not

office to discuss their License: NP95004366 present.

accessibility needs when there Credentials and/or board

is limited access or when certification: No

accessibility indicators are not Accepting New Members: Yes Gil, Anna NP

present. Hours: M-SA 9AM-5PM 752 Medical Center Ct Ste 302

PTA: No Chula Vista, CA 91911

91911 Cultural Competency: NR

Accessibility: B; Members

(858) 810-8000

Provider ID: 268794

Akins, Melanie NP should call the provider’s License: NP95004447

752 Medical Center Ct Ste 302 office to discuss their Credentials and/or board

Chula Vista, CA 91911 accessibility needs when there certification: No

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 50

Page 73: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

EL CAJON

92020

Brannen, Mandy NP

215 W Madison Ave

El Cajon, CA 92020

(619) 401-6236

Provider ID: 241600

License: NP95007286

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Chudacek, Janet NP

215 W Madison Ave

El Cajon, CA 92020

(760) 737-6960

Provider ID: 241626

License: NP95008776

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ENCINITAS

92024

Binavi, Hownaz NP

477 N El Camino Real Ste D308

Encinitas, CA 92024

(760) 436-2300

Provider ID: 265370

License: NP95010956

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Kurdish,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Elamparo, Kaye NP

477 N El Camino Real Ste D200

Encinitas, CA 92024

(760) 452-3340

Provider ID: 258927

License: NP20795

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Korean,

Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 51

Page 74: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

present.

Franz, Cortney NP

477 N El Camino Real Ste D200

Encinitas, CA 92024

(760) 452-3340

Provider ID: 253241

License: NP95004258

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Faiq, Jamila NP

477 N El Camino Real Ste D200

Encinitas, CA 92024

(760) 452-3340

Provider ID: 254824

License: NP95004759

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Hooper, Bonnie NP

477 N El Camino Real Ste D308

Encinitas, CA 92024

(760) 436-2300

Provider ID: 275253

License: NP6495

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Mwaura, Wairimu NP

477 N El Camino Real Ste D200

Encinitas, CA 92024

(760) 452-3340

Provider ID: 269680

License: NP95009639

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Tablada, Derlyn NP

1130 2nd St

Encinitas, CA 92024

(760) 753-7842

Provider ID: 246117

License: NP95008061

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Tagalog

Cultural Competency: NR

Accessibility: B; Members

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 52

Page 75: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Tawfilis, Amy NP

320 Santa Fe Dr Ste 108

Encinitas, CA 92024

(760) 436-4558

Provider ID: 276750

License: NP95013902

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Willey, Marti NP

477 N El Camino Real Ste D200

Encinitas, CA 92024

(760) 452-3340

Provider ID: 256422

License: NP22548

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ESCONDIDO

92025

Pidding, Apryl NP

625 Citracado Pkwy Ste 110

Escondido, CA 92025

(760) 747-8935

Provider ID: 269252

License: NP20027

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Spaulding, Enjoli NP

631 E Grand Ave

Escondido, CA 92025

(760) 294-1660

Provider ID: 269259

License: NP21947

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92027

Murray, Carla NP

1509 E Valley Pkwy

Escondido, CA 92027

(760) 520-8100

Provider ID: 242749

License: NP12682

Credentials and/or board

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 53

Page 76: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Hours: M-SA 9AM-5PM Bishop, Leslie NP

PTA: No 1955 Citracado Pkwy Ste 102

Cultural Competency: NR Escondido, CA 92029

Accessibility: B; Members (760) 630-3000

should call the provider’s Provider ID: 243219

office to discuss their License: NP95010047

accessibility needs when there Credentials and/or board

is limited access or when certification: No

accessibility indicators are not Accepting New Members: Yes

present. Hours: M-SA 9AM-5PM

PTA: No

92029 Cultural Competency: NR

Accessibility: B; Members

Barmack, Kimberly NP should call the provider’s

1955 Citracado Pkwy Ste 200 office to discuss their

Escondido, CA 92029 accessibility needs when there

(760) 743-4789 is limited access or when

Provider ID: 269270 accessibility indicators are not

License: NP20705 present.

Credentials and/or board

certification: No

Accepting New Members: Yes Meyers, Judith NP

Hours: M-SA 9AM-5PM 1955 Citracado Pkwy Ste 300

PTA: No Escondido, CA 92029

Cultural Competency: NR (760) 743-4789

Accessibility: B; Members Provider ID: 274695

should call the provider’s License: NP95010314

office to discuss their Credentials and/or board

accessibility needs when there certification: No

is limited access or when Accepting New Members: Yes

accessibility indicators are not Hours: M-SA 9AM-5PM

present. PTA: No

certification: No

Accepting New Members: Yes

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Mitruka, Anne NP

1955 Citracado Pkwy Ste 300

Escondido, CA 92029

(760) 743-0546

Provider ID: 269427

License: NP13563

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA JOLLA

92037

Elamparo, Kaye NP

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 54

Page 77: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

9834 Genesee Ave Ste 560

La Jolla, CA 92037

(858) 552-1710

Provider ID: 258928

License: NP20795

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Korean,

Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Haley, Kathleen NP

9850 Genesee Ave Ste 560

La Jolla, CA 92037

(858) 552-1410

Provider ID: 253506

License: NP11124

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Tawfilis, Amy NP

9850 Genesee Ave Ste 440

La Jolla, CA 92037

(858) 453-5944

Provider ID: 276749

License: NP95013902

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Tomicich, Stephanie NP

9834 Genesee Ave Ste 416

La Jolla, CA 92037

(858) 458-0099

Provider ID: 248026

License: NP95002402

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA MESA

91942

Loyola, Mary Ann NP

8851 Center Dr Ste 505

La Mesa, CA 91942

(619) 461-3880

Provider ID: 242398

License: NP95011408

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 55

Page 78: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

office to discuss their (844) 200-2426 office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

NATIONAL CITY

91950

Aquino, Felino NP

2101 Granger Ave Ste 101a

National City, CA 91950

(844) 200-2426

Provider ID: 244332

License: NP22974

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Aquino, Felino NP

2743 Highland Ave

National City, CA 91950

Provider ID: 244335

License: NP22974

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Aquino, Felino NP

2835 Highland Ave Ste B

National City, CA 91950

(844) 200-2426

Provider ID: 244336

License: NP22974

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Bernardo-gregory, Elsie NP

1428 Highland Ave

National City, CA 91950

(760) 631-5000

Provider ID: 244828

License: NP15257

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Bernardo-gregory, Elsie NP

2835 Highland Ave Ste B

National City, CA 91950

(844) 200-2426

Provider ID: 244833

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 56

Page 79: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

License: NP15257

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

De Roldan, Sandra NP

610 Euclid Ave Ste 302

National City, CA 91950

(619) 527-7700

Provider ID: 269289

License: NP22506

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Gil, Anna NP

655 Euclid Ave Ste 405

National City, CA 91950

(619) 479-0822

Provider ID: 268795

License: NP95004447

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Khan, Matthew NP

1428 Highland Ave

National City, CA 91950

(619) 474-2284

Provider ID: 238376

License: NP17838

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

OCEANSIDE

92054

Chamberlin, Kaliana NP

517 N Horne St

Oceanside, CA 92054

(760) 631-5000

Provider ID: 273018

License: NP95013030

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 57

Page 80: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Other Language: Spanish 818 Pier View Way

Clark, Cynthia NP Cultural Competency: NR Oceanside, CA 92054

517 N Horne St Accessibility: B; Members (760) 631-5000

Oceanside, CA 92054 should call the provider’s Provider ID: 245672

(844) 308-5003 office to discuss their License: NP95007944

Provider ID: 240002 accessibility needs when there Credentials and/or board

License: NP16833 is limited access or when certification: No

Credentials and/or board accessibility indicators are not Accepting New Members: Yes

certification: No present. Hours: M-SA 9AM-5PM

Accepting New Members: Yes PTA: No

Hours: M-SA 9AM-5PM Cultural Competency: NR

PTA: No Dapper, Madeline NP Accessibility: B; Members

Other Language: Spanish 818 Pier View Way should call the provider’s

Cultural Competency: NR Oceanside, CA 92054 office to discuss their

Accessibility: B; Members (760) 631-5000 accessibility needs when there

should call the provider’s Provider ID: 278002 is limited access or when

office to discuss their License: NP95016147 accessibility indicators are not

accessibility needs when there Credentials and/or board present.

is limited access or when certification: No

accessibility indicators are not Accepting New Members: Yes 92057 present. Hours: M-SA 9AM-5PM

PTA: No Clark, Cynthia NP

Other Language: Spanish 4700 N River Rd

Clark, Cynthia NP Cultural Competency: NR Oceanside, CA 92057

818 Pier View Way Accessibility: B; Members (844) 308-5003

Oceanside, CA 92054 should call the provider’s Provider ID: 240004

(844) 308-5003 office to discuss their License: NP16833

Provider ID: 240003 accessibility needs when there Credentials and/or board

License: NP16833 is limited access or when certification: No

Credentials and/or board accessibility indicators are not Accepting New Members: Yes

certification: No present. Hours: M-SA 9AM-5PM

Accepting New Members: Yes PTA: No

Hours: M-SA 9AM-5PM Other Language: Spanish

PTA: No Skopek, Rory NP Cultural Competency: NR

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 58

Page 81: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Accessibility: B; Members (760) 631-5000 office to discuss their

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Eklund, Bonnie NP

4700 N River Rd

Oceanside, CA 92057

(760) 631-5000

Provider ID: 243625

License: NP15285

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: French

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Pritzker, Joely NP

4700 N River Rd

Oceanside, CA 92057

Provider ID: 239772

License: NP95000955

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Santiago, Amanda NP

4700 N River Rd

Oceanside, CA 92057

(760) 631-5000

Provider ID: 242607

License: NP95007724

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

POWAY

92064

Bishop, Leslie NP

15611 Pomerado Rd Ste 505

Poway, CA 92064

(760) 631-3000

Provider ID: 243218

License: NP95010047

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Meyers, Judith NP

15611 Pomerado Rd Ste 400

Poway, CA 92064

(858) 675-3100

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 59

Page 82: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Provider ID: 257040

License: NP95010314

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Wright, Kimberly NP

15611 Pomerado Rd Ste 400

Poway, CA 92064

(858) 675-3200

Provider ID: 256378

License: NP95006947

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92102

Watson, Christine NP

995 Gateway Center Way Ste

202

San Diego, CA 92102

(619) 264-3107

Provider ID: 270000

License: NP95006319

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92103

Dwyer, Erin NP

4060 4th Ave Ste 310

San Diego, CA 92103

(619) 297-4707

Provider ID: 269863

License: NP95004184

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Hooper, Bonnie NP

4060 4th Ave Ste 415

San Diego, CA 92103

(619) 298-9809

Provider ID: 275255

License: NP6495

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 60

Page 83: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

accessibility indicators are not

present.

Luckett, De Courcy NP

3520 4th Ave

San Diego, CA 92103

(714) 619-8777

Provider ID: 271115

License: NP95000435

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Pruett, Zhike NP

555 Washington St

San Diego, CA 92103

(949) 209-3473

Provider ID: 269841

License: NP22373

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92114

Buenvenida, Amelia NP

903 Cardiff St

San Diego, CA 92114

(619) 465-3121

Provider ID: 259394

License: NP95004301

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92121

Hooper, Bonnie NP

9339 Genesee Ave Ste 350

San Diego, CA 92121

(858) 454-4300

Provider ID: 275254

License: NP6495

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92123

Albano, Rizalina NP

9610 Granite Ridge Dr Ste B

San Diego, CA 92123

(619) 461-3880

Provider ID: 271000

License: NP95005436

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 61

Page 84: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

PTA: No 3444 Kearny Villa Rd Ste 202 should call the provider’s

Other Language: Tagalog San Diego, CA 92123 office to discuss their

Cultural Competency: NR (858) 429-7646 accessibility needs when there

Accessibility: B; Members Provider ID: 270968 is limited access or when

should call the provider’s License: PA53170 accessibility indicators are not

office to discuss their Credentials and/or board present.

accessibility needs when there certification: No

is limited access or when Accepting New Members: Yes

accessibility indicators are not Hours: M-SA 9AM-5PM Camargo-lowthers, Angelica

present. PTA: No CNP

Cultural Competency: NR 8010 Frost St Ste 510

Accessibility: B; Members San Diego, CA 92123

Bird, Jeremy NP should call the provider’s (858) 637-4700

3444 Kearny Villa Rd Ste 202 office to discuss their Provider ID: 270981

San Diego, CA 92123 accessibility needs when there License: NP14412

(858) 429-7646 is limited access or when Credentials and/or board

Provider ID: 270968 accessibility indicators are not certification: No

License: NP18833 present. Accepting New Members: Yes

Credentials and/or board Hours: M-SA 9AM-5PM

certification: No PTA: No

Accepting New Members: Yes Camargo-lowthers, Angelica Cultural Competency: NR

Hours: M-SA 9AM-5PM CNP Accessibility: B; Members

PTA: No 8010 Frost St Ste 510 should call the provider’s

Cultural Competency: NR San Diego, CA 92123 office to discuss their

Accessibility: B; Members (858) 637-4700 accessibility needs when there

should call the provider’s Provider ID: 270981 is limited access or when

office to discuss their License: RN521048 accessibility indicators are not

accessibility needs when there Credentials and/or board present.

is limited access or when certification: No

accessibility indicators are not Accepting New Members: Yes

present. Hours: M-SA 9AM-5PM Hecker, Carol NP

PTA: No 7901 Frost St

Cultural Competency: NR San Diego, CA 92123

Bird, Jeremy NP Accessibility: B; Members (858) 565-0104

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 62

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Provider ID: 270984

License: NP17354

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92127

Moga, Claire NP

16918 Dove Canyon Rd Ste

103

San Diego, CA 92127

(858) 649-5100

Provider ID: 257026

License: NP95007255

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Willey, Marti NP

16918 Dove Canyon Rd Ste

103

San Diego, CA 92127

(858) 643-5100

Provider ID: 256421

License: NP22548

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92128

Moll, Jocelyn NP

11770 Bernardo Plaza Ct Ste

270

San Diego, CA 92128

(858) 485-0554

Provider ID: 276040

License: NP95010975

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92129

Aquino, Felino NP

9995 Carmel Mountain Rd Ste

B10-b11

San Diego, CA 92129

(844) 200-2426

Provider ID: 244334

License: NP22974

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 63

Page 86: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Bernardo-gregory, Elsie NP

9995 Carmel Mountain Rd Ste

B10

San Diego, CA 92129

(844) 200-2426

Provider ID: 244829

License: NP15257

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Bernardo-gregory, Elsie NP

9995 Carmel Mountain Rd Ste

B11

San Diego, CA 92129

(844) 200-2426

Provider ID: 244830

License: NP15257

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Orpilla, Imelda NP

9995 Carmel Mountain Rd Ste

B10-b11

San Diego, CA 92129

(844) 200-2426

Provider ID: 243506

License: NP95003211

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92131

Aquino, Felino NP

9855 Erma Rd Ste 105

San Diego, CA 92131

(844) 200-2426

Provider ID: 244333

License: NP22974

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN MARCOS

92069

Coyle, Jennifer NP

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 64

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

838 Nordahl Rd Ste 300 should call the provider’s License: NP95009639

San Marcos, CA 92069 office to discuss their Credentials and/or board

(760) 748-8935 accessibility needs when there certification: No

Provider ID: 253094 is limited access or when Accepting New Members: Yes

License: NP95006591 accessibility indicators are not Hours: M-SA 9AM-5PM

Credentials and/or board present. PTA: No

certification: No Cultural Competency: NR

Accepting New Members: Yes Accessibility: B; Members

Hours: M-SA 9AM-5PM Faiq, Jamila NP should call the provider’s

PTA: No 838 Nordahl Rd Ste 300 office to discuss their

Cultural Competency: NR San Marcos, CA 92069 accessibility needs when there

Accessibility: B; Members (760) 474-8935 is limited access or when

should call the provider’s Provider ID: 254825 accessibility indicators are not

office to discuss their License: NP95004759 present.

accessibility needs when there Credentials and/or board

is limited access or when certification: No

accessibility indicators are not Accepting New Members: Yes Moga, Claire NP

present. Hours: M-SA 9AM-5PM 838 Nordahl Rd Fl 3

PTA: No San Marcos, CA 92069

Cultural Competency: NR (760) 747-8935

Franz, Cortney NP Accessibility: B; Members Provider ID: 257025

838 Nordahl Rd Ste 300 should call the provider’s License: NP95007255

San Marcos, CA 92069 office to discuss their Credentials and/or board

(760) 474-8935 accessibility needs when there certification: No

Provider ID: 257616 is limited access or when Accepting New Members: Yes

License: NP95004258 accessibility indicators are not Hours: M-SA 9AM-5PM

Credentials and/or board present. PTA: No

certification: No Cultural Competency: NR

Accepting New Members: Yes Accessibility: B; Members

Hours: M-SA 9AM-5PM Mwaura, Wairimu NP should call the provider’s

PTA: No 838 Nordahl Rd Ste 300 office to discuss their

Other Language: Spanish San Marcos, CA 92069 accessibility needs when there

Cultural Competency: NR (760) 747-8935 is limited access or when

Accessibility: B; Members Provider ID: 269681 accessibility indicators are not

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 65

Page 88: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

present. certification: No

VISTA

92083

Clark, Cynthia NP

134 Grapevine Rd

Vista, CA 92083

(760) 631-5000

Provider ID: 240000

License: NP16833

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Clark, Cynthia NP

105 Durian St Ste C

Vista, CA 92083

(760) 631-5000

Provider ID: 240005

License: NP16833

Credentials and/or board

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Cory, Allison NP

134 Grapevine Rd

Vista, CA 92083

(760) 631-5000

Provider ID: 245207

License: NP20497

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Dapper, Madeline NP

134 Grapevine Rd

Vista, CA 92083

(760) 631-5000

Provider ID: 278001

License: NP95016147

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Eklund, Bonnie NP

134 Grapevine Rd

Vista, CA 92083

(760) 631-5000

Provider ID: 243624

License: NP15285

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 66

Page 89: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

PTA: No

Other Language: French

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Kahl, Nicholas NP

134 Grapevine Rd

Vista, CA 92083

(760) 631-5000

Provider ID: 279942

License: NP95006360

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92084

Alvarez, Lisa NP

1000 Vale Terrace Dr

Vista, CA 92084

(760) 631-5000

Provider ID: 278537

License: NP19911

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Chamberlin, Kaliana NP

1000 Vale Terrace Dr

Vista, CA 92084

(760) 631-5000

Provider ID: 271067

License: NP95013030

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Clark, Cynthia NP

1000 Vale Terrace Dr

Vista, CA 92084

(844) 308-5003

Provider ID: 240001

License: NP16833

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Dapper, Madeline NP

1000 Vale Terrace Dr

Vista, CA 92084

(760) 631-5000

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 67

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Provider ID: 278000 office to discuss their License: NP95006826

License: NP95016147 accessibility needs when there Credentials and/or board

Credentials and/or board is limited access or when certification: No

certification: No accessibility indicators are not Accepting New Members: Yes

Accepting New Members: Yes present. Hours: M-SA 9AM-5PM

Hours: M-SA 9AM-5PM PTA: No

PTA: No Other Language: Chinese

Other Language: Spanish Eklund, Bonnie NP Cultural Competency: NR

Cultural Competency: NR 1000 Vale Terrace Dr Accessibility: B; Members

Accessibility: B; Members Vista, CA 92084 should call the provider’s

should call the provider’s (760) 631-5000 office to discuss their

office to discuss their Provider ID: 243623 accessibility needs when there

accessibility needs when there License: NP15285 is limited access or when

is limited access or when Credentials and/or board accessibility indicators are not

accessibility indicators are not certification: No present.

present. Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No Kousari, Jhaleh NP

Dekkers-o'hare, Ingrid NP Other Language: French 1000 Vale Terrace Dr

1000 Vale Terrace Dr Cultural Competency: NR Vista, CA 92084

Vista, CA 92084 Accessibility: B; Members (760) 631-5000

(760) 631-5000 should call the provider’s Provider ID: 239793

Provider ID: 241299 office to discuss their License: NP20893

License: NP8665 accessibility needs when there Credentials and/or board

Credentials and/or board is limited access or when certification: No

certification: No accessibility indicators are not Accepting New Members: Yes

Accepting New Members: Yes present. Hours: M-SA 9AM-5PM

Hours: M-SA 9AM-5PM PTA: No

PTA: No Other Language: Farsi,

Other Language: Spanish, Halgedahl, Yi NP Spanish

Vietnamese 1000 Vale Terrace Dr Cultural Competency: NR

Cultural Competency: NR Vista, CA 92084 Accessibility: B; Members

Accessibility: B; Members (760) 631-5000 should call the provider’s

should call the provider’s Provider ID: 241907 office to discuss their

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 68

Page 91: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Nicholas, Estela NP

1000 Vale Terrace Dr

Vista, CA 92084

(760) 631-5000

Provider ID: 239866

License: NP11448

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Pateman, Carolyn NP

1000 Vale Terrace Dr

Vista, CA 92084

(760) 631-5000

Provider ID: 239976

License: NP10896

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Pritzker, Joely NP

1000 Vale Terrace Dr

Vista, CA 92084

(760) 631-5000

Provider ID: 239773

License: NP95000955

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Smith, Sharon NP

1000 Vale Terrace Dr

Vista, CA 92084

(760) 631-5000

Provider ID: 242508

License: NP15444

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Smith, Sharon NP

1000 Vale Terrace Dr

Vista, CA 92084

(760) 631-5000

Provider ID: 242508

License: RN428876

Credentials and/or board

certification: No

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 69

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Certified Registered Nurse

Anesthetist

ESCONDIDO

92025

Seilnacht Bernard, Karen

CRNA

488 E Valley Pkwy

Escondido, CA 92025

(760) 203-5321

Provider ID: 269203

License: RN409982

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Seilnacht Bernard, Karen

CRNA

488 E Valley Pkwy

Escondido, CA 92025

(760) 203-5321

Provider ID: 269203

License: NA1876

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA JOLLA

92037

Serrano, Melinda CRNA

9300 Campus Point Dr

La Jolla, CA 92037

(619) 543-5754

Provider ID: 269366

License: NA95000147

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Dermatology

CARLSBAD

92011

Brouha, Brook MD

6010 Hidden Valley Rd Ste 120

Carlsbad, CA 92011

(760) 884-5990

Provider ID: 267945

License: A97902

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: French

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 70

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Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Special Expertise: HIV/AIDS

CHULA VISTA

91910

Stein, Alexander MD

340 Fourth Ave Ste 14

Chula Vista, CA 91910

(619) 303-3681

Provider ID: 268620

License: A106295

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: French,

Romanian

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

EL CAJON

92020

Brogan, Jacqueline MD

292 Avocado Ave

El Cajon, CA 92020

(619) 579-5115

Provider ID: 265251

License: A160890

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Cohen, Philip MD

292 Avocado Ave

El Cajon, CA 92020

(619) 579-5115

Provider ID: 202211

License: G89274

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Crowley, Christopher MD

292 Avocado Ave

El Cajon, CA 92020

(619) 579-5115

Provider ID: 269669

License: A134188

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 71

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Other Language: Chinese,

Celano, Nicholas MD Mandarin, Spanish Resh, William MD

292 Avocado Ave Cultural Competency: NR 292 Avocado Ave

El Cajon, CA 92020 Accessibility: B; Members El Cajon, CA 92020

(619) 579-5115 should call the provider’s (619) 579-5115

Provider ID: 269114 office to discuss their Provider ID: 269099

License: A120411 accessibility needs when there License: C34661

Credentials and/or board is limited access or when Credentials and/or board

certification: No accessibility indicators are not certification: No

Accepting New Members: Yes present. Accepting New Members: Yes

Hours: M-SA 9AM-5PM Hours: M-SA 9AM-5PM

PTA: No PTA: No

Other Language: Spanish Kassab, Ghada MD Cultural Competency: NR

Cultural Competency: NR 330 S Magnolia Ave Accessibility: B; Members

Accessibility: B; Members El Cajon, CA 92020 should call the provider’s

should call the provider’s (858) 273-2726 office to discuss their

office to discuss their Provider ID: 129190 accessibility needs when there

accessibility needs when there License: A114457 is limited access or when

is limited access or when Credentials and/or board accessibility indicators are not

accessibility indicators are not certification: No present.

present. Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No Sateesh, Brooke MD

Chiang, Jennifer MD Other Language: Arabic, 292 Avocado Ave

292 Avocado Ave Spanish El Cajon, CA 92020

El Cajon, CA 92020 Cultural Competency: NR (619) 579-5115

(619) 579-5115 Accessibility: B; Members Provider ID: 269154

Provider ID: 269156 should call the provider’s License: A109670

License: A120528 office to discuss their Credentials and/or board

Credentials and/or board accessibility needs when there certification: No

certification: No is limited access or when Accepting New Members: Yes

Accepting New Members: Yes accessibility indicators are not Hours: M-SA 9AM-5PM

Hours: M-SA 9AM-5PM present. PTA: No

PTA: No Cultural Competency: NR

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 72

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Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ENCINITAS

92024

Gladsjo, Julie MD

477 N El Camino Real Ste D308

Encinitas, CA 92024

(760) 436-2300

Provider ID: 269052

License: A98641

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Hemperly, Stephen DO

477 N El Camino Real Ste D308

Encinitas, CA 92024

(760) 436-2300

Provider ID: 243725

License: 20A14658

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Riley, Jessica DO

477 N El Camino Real Ste D308

Encinitas, CA 92024

(760) 436-2300

Provider ID: 243457

License: 20A16345

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Tompkins, Stacy MD

477 N El Camino Real Ste D308

Encinitas, CA 92024

(760) 436-2300

Provider ID: 246363

License: A52958

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: French,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

FALLBROOK

92028

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 73

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Ross, Andrew MD

1309 S Mission Rd Ste A

Fallbrook, CA 92028

(760) 728-7546

Provider ID: 269334

License: A140430

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Samady, Joseph MD

1309 S Mission Rd Ste A

Fallbrook, CA 92028

(760) 728-7546

Provider ID: 269328

License: A71411

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA JOLLA

92037

Crowley, Christopher MD

9300 Campus Point Dr

La Jolla, CA 92037

(858) 657-8322

Provider ID: 269668

License: A134188

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Miremadi, Arjamg MD

7702 Ivanhoe Ave

La Jolla, CA 92037

(858) 456-1840

Provider ID: 122520

License: A31016

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Farsi,

Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

NATIONAL CITY

91950

Brogan, Jacqueline MD

655 Euclid Ave Ste 401

National City, CA 91950

(619) 267-8303

Provider ID: 265250

License: A160890

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 74

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Other Language: Spanish 655 Euclid Ave Ste 401 should call the provider’s

Cultural Competency: NR National City, CA 91950 office to discuss their

Accessibility: B; Members (619) 267-8303 accessibility needs when there

should call the provider’s Provider ID: 269667 is limited access or when

office to discuss their License: A134188 accessibility indicators are not

accessibility needs when there Credentials and/or board present.

is limited access or when certification: No

accessibility indicators are not Accepting New Members: Yes

present. Hours: M-SA 9AM-5PM Chiang, Jennifer MD

PTA: No 655 Euclid Ave Ste 401

Cultural Competency: NR National City, CA 91950

Cohen, Philip MD Accessibility: B; Members (619) 267-8303

655 Euclid Ave Ste 401 should call the provider’s Provider ID: 269157

National City, CA 91950 office to discuss their License: A120528

(619) 267-8303 accessibility needs when there Credentials and/or board

Provider ID: 202210 is limited access or when certification: No

License: G89274 accessibility indicators are not Accepting New Members: Yes

Credentials and/or board present. Hours: M-SA 9AM-5PM

certification: No PTA: No

Accepting New Members: Yes Other Language: Chinese,

Hours: M-SA 9AM-5PM Celano, Nicholas MD Mandarin, Spanish

PTA: No 655 Euclid Ave Ste 401 Cultural Competency: NR

Other Language: Spanish National City, CA 91950 Accessibility: B; Members

Cultural Competency: NR (619) 267-8303 should call the provider’s

Accessibility: B; Members Provider ID: 269115 office to discuss their

should call the provider’s License: A120411 accessibility needs when there

office to discuss their Credentials and/or board is limited access or when

accessibility needs when there certification: Yes accessibility indicators are not

is limited access or when Accepting New Members: Yes present.

accessibility indicators are not Hours: M-SA 9AM-5PM

present. PTA: No

Other Language: Spanish Nelson, Aislyn MD

Cultural Competency: NR 655 Euclid Ave Ste 401

Crowley, Christopher MD Accessibility: B; Members National City, CA 91950

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 75

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

(619) 267-8303 accessibility needs when there certification: No

Provider ID: 246490

License: A147913

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Resh, William MD

655 Euclid Ave Ste 401

National City, CA 91950

(619) 267-8303

Provider ID: 269100

License: C34661

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

is limited access or when

accessibility indicators are not

present.

Sateesh, Brooke MD

655 Euclid Ave Ste 401

National City, CA 91950

(619) 267-8303

Provider ID: 269155

License: A109670

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Uebelhoer, Nathan DO

655 Euclid Ave Ste 401

National City, CA 91950

(619) 267-8303

Provider ID: 269137

License: 20A9328

Credentials and/or board

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

OCEANSIDE

92056

Angra, Kunal MD

3629 Vista Way

Oceanside, CA 92056

(760) 757-7546

Provider ID: 276058

License: A161745

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 76

Page 99: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

present. Hours: M-SA 9AM-5PM present.

PTA: Yes

Other Language: Danish,

Aguirre, Kristen MD German, Hebrew, Ross, Andrew MD

3629 Vista Way Norwegian, Polish, Spanish, 3629 Vista Way

Oceanside, CA 92056 Swedish Oceanside, CA 92056

(760) 757-7546 Cultural Competency: NR (760) 757-7546

Provider ID: 243076 Accessibility: B; Members Provider ID: 269333

License: A135075 should call the provider’s License: A140430

Credentials and/or board office to discuss their Credentials and/or board

certification: No accessibility needs when there certification: No

Accepting New Members: Yes is limited access or when Accepting New Members: Yes

Hours: M-SA 9AM-5PM accessibility indicators are not Hours: M-SA 9AM-5PM

PTA: No present. PTA: No

Other Language: Spanish Other Language: Spanish

Cultural Competency: NR Cultural Competency: NR

Accessibility: B; Members Kim, Jessica DO Accessibility: B; Members

should call the provider’s 3629 Vista Way should call the provider’s

office to discuss their Oceanside, CA 92056 office to discuss their

accessibility needs when there (760) 757-7546 accessibility needs when there

is limited access or when Provider ID: 247630 is limited access or when

accessibility indicators are not License: 20A17031 accessibility indicators are not

present. Credentials and/or board present.

certification: No

Accepting New Members: Yes

Gilboa, Ruth MD Hours: M-SA 9AM-5PM Samady, Joseph MD

3629 Vista Way PTA: No 3629 Vista Way

Oceanside, CA 92056 Cultural Competency: NR Oceanside, CA 92056

(760) 757-7546 Accessibility: B; Members (760) 757-7546

Provider ID: 269414 should call the provider’s Provider ID: 269327

License: A46557 office to discuss their License: A71411

Credentials and/or board accessibility needs when there Credentials and/or board

certification: No is limited access or when certification: Yes

Accepting New Members: Yes accessibility indicators are not Accepting New Members: Yes

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 77

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Hours: M-SA 9AM-5PM 3629 Vista Way office to discuss their

PTA: Yes

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Thiele, Jens MD

3629 Vista Way

Oceanside, CA 92056

(760) 757-7546

Provider ID: 269412

License: A103862

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Venkat, Arun MD

Oceanside, CA 92056

(760) 757-7546

Provider ID: 269345

License: A125103

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Wong, Darryl MD

3629 Vista Way

Oceanside, CA 92056

(760) 757-7546

Provider ID: 269368

License: G70557

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

POWAY

92064

Armstrong, Patrick MD

15611 Pomerado Rd Ste 400

Poway, CA 92064

(858) 675-3145

Provider ID: 269732

License: A137103

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Jou, Paul MD

15611 Pomerado Rd Ste 400

Poway, CA 92064

(858) 675-3145

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 78

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Provider ID: 269479

License: A148966

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Shewmake, Stephen MD

15611 Pomerado Rd Ste 400

Poway, CA 92064

(858) 675-3140

Provider ID: 88451

License: G36481

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92103

Boen, Monica MD

4060 4th Ave Ste 415

San Diego, CA 92103

(619) 298-9809

Provider ID: 269741

License: A149554

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: French,

Polish, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Hamman, Michael MD

4060 4th Ave Ste 415

San Diego, CA 92103

(619) 298-9809

Provider ID: 241043

License: A97551

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Hemperly, Stephen DO

4060 4th Ave Ste 415

San Diego, CA 92103

(619) 298-9809

Provider ID: 243726

License: 20A14658

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 79

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

accessibility indicators are not

present.

Levin, Jacqueline DO

4060 4th Ave Ste 415

San Diego, CA 92103

(619) 298-9809

Provider ID: 242685

License: 20A12190

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Special Expertise: HIV/AIDS

Reed, Kelly DO

4060 4th Ave Ste 415

San Diego, CA 92103

(619) 298-9809

Provider ID: 242598

License: 20A15550

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Shiell, Ronald MD

4060 4th Ave Ste 415

San Diego, CA 92103

(619) 289-9809

Provider ID: 242596

License: G70359

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Simzar, Soheil MD

4060 4th Ave Ste 415

San Diego, CA 92103

(619) 298-9809

Provider ID: 242621

License: A97769

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Zaleski Larsen, Lisa DO

4060 4th Ave Ste 415

San Diego, CA 92103

(619) 298-9809

Provider ID: 242549

License: 20A13774

Credentials and/or board

certification: No

Accepting New Members: Yes

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 80

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92117

Kassab, Ghada MD

3737 Moraga Ave Ste A206

San Diego, CA 92117

(858) 273-2726

Provider ID: 245638

License: A114457

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92119

Stein, Alexander MD

6280 Jackson Dr Ste 8

San Diego, CA 92119

(619) 303-3062

Provider ID: 268621

License: A106295

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: French,

Romanian

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92120

Shahan, Fred MD

6367 Alvarado Ct Ste 107

San Diego, CA 92120

(619) 287-1882

Provider ID: 65605

License: G83901

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Farsi,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92121

Boen, Monica MD

9339 Genesee Ave Ste 350

San Diego, CA 92121

(858) 454-4300

Provider ID: 269740

License: A149554

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: French,

Polish, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 81

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

is limited access or when

accessibility indicators are not

present.

Reed, Kelly DO

9339 Genesee Ave Ste 350

San Diego, CA 92121

(858) 454-4300

Provider ID: 242599

License: 20A15550

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Tompkins, Stacy MD

9333 Genesee Ave Ste 350a

San Diego, CA 92121

(858) 454-4300

Provider ID: 246364

License: A52958

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: French,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92123

Nahm, Walter MD

7695 Cardinal Ct Ste 200

San Diego, CA 92123

(858) 278-8835

Provider ID: 69317

License: A78569

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Korean,

Spanish, Tagalog

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92130

Gray, Jayla MD

4765 Carmel Mountain Rd Ste

201

San Diego, CA 92130

(858) 369-7546

Provider ID: 279378

License: A169832

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN MARCOS

92069

Kim, Jessica DO

838 Nordahl Rd Ste 250

San Marcos, CA 92069

(760) 738-7600

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 82

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Provider ID: 247631

License: 20A17031

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Venkat, Arun MD

838 Nordahl Rd Ste 250

San Marcos, CA 92069

(760) 738-7600

Provider ID: 269347

License: A125103

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SOLANA BEACH

92075

Gilboa, Ruth MD

530 Lomas Santa Fe Dr Ste D

Solana Beach, CA 92075

(858) 259-0056

Provider ID: 269415

License: A46557

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Danish,

German, Hebrew,

Norwegian, Polish, Spanish,

Swedish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Ross, Andrew MD

530 Lomas Santa Fe Dr Ste D

Solana Beach, CA 92075

(858) 259-0056

Provider ID: 269335

License: A140430

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Venkat, Arun MD

530 Lomas Santa Fe Dr Ste D

Solana Beach, CA 92075

(858) 259-2256

Provider ID: 269346

License: A125103

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 83

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Emergency Medicine

POWAY

92064

Fiore, Joseph MD

15611 Pomerado Rd Fl 3 North

Poway, CA 92064

(858) 675-3200

Provider ID: 269787

License: A42159

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Endocrinology

CHULA VISTA

91910

Rogers, Megan MD

480 4th Ave Ste 202

Chula Vista, CA 91910

(619) 427-3362

Provider ID: 268585

License: A122784

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Family Practice Sports

Medicine

SAN DIEGO

92127

Spring, Jason DO

16918 Dove Canyon Rd

San Diego, CA 92127

(858) 924-1900

Provider ID: 271551

License: 20A9497

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Family Practice

CARLSBAD

92011

Madhav, Kinjal MD

6010 Hidden Valley Rd Ste 200

Carlsbad, CA 92011

(760) 631-3000

Provider ID: 244004

License: A132338

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Gujarati,

Hindi, Spanish

Cultural Competency: NR

Accessibility: B; Members

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 84

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Female Pelvic Med and

Reconstructive Surg

Moukarzel, Elias MD

6125 Paseo Del Norte Ste 140

Carlsbad, CA 92011

(760) 352-4103

Provider ID: 269151

License: C50303

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

French, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Gastroenterology

CHULA VISTA

91910

Duque, John MD

480 4th Ave Ste 316

Chula Vista, CA 91910

(619) 691-0240

Provider ID: 268572

License: G48442

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Hassanein, Tarek MD

256 Landis Ave Ste 202

Chula Vista, CA 91910

(619) 332-1221

Provider ID: 269555

License: A54452

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

French, German, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

91911

Hassanein, Tarek MD

1323 3rd Ave

Chula Vista, CA 91911

(619) 409-6900

Provider ID: 269558

License: A54452

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

French, German, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 85

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

accessibility indicators are not

present.

CORONADO

92118

Gutierrez, Julio MD

131 Orange Ave Ste 101

Coronado, CA 92118

(619) 522-0399

Provider ID: 270435

License: A107985

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Lajin, Michael MD

230 Prospect Pl Ste 220

Coronado, CA 92118

(619) 460-4055

Provider ID: 269837

License: C53475

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

German, Japanese, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

EL CAJON

92020

Hassanein, Tarek MD

463 N Magnolia Ave

El Cajon, CA 92020

(619) 522-0399

Provider ID: 269556

License: A54452

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

French, German, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Imperial, Joanne MD

465 N Magnolia Ave

El Cajon, CA 92020

(619) 359-8380

Provider ID: 268979

License: G44420

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: French,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ENCINITAS

92024

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 86

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Singh, Marvin MD

700 Garden View Ct Ste 102

Encinitas, CA 92024

(760) 783-0441

Provider ID: 123127

License: A102749

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Korean,

Russian, Spanish, Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

OCEANSIDE

92056

Chiao, Hellen MD

3923 Waring Rd Ste A

Oceanside, CA 92056

(760) 724-8782

Provider ID: 128127

License: A127722

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Cantonese,

Mandarin, Spanish,

Taiwanese, Yue Chinese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Devereaux, Christopher MD

3923 Waring Rd Ste A

Oceanside, CA 92056

(760) 724-8782

Provider ID: 41551

License: G75223

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Krol, Thomas MD

3923 Waring Rd Ste A

Oceanside, CA 92056

(760) 724-8782

Provider ID: 41549

License: G43649

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Shad, Javaid MD

3923 Waring Rd Ste A

Oceanside, CA 92056

(760) 724-8782

Provider ID: 41554

License: G86962

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 87

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Other Language: Hindi, Urdu

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Shim, Michael MD

3923 Waring Rd Ste A

Oceanside, CA 92056

(760) 724-8782

Provider ID: 41553

License: A88942

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Viernes, Matthew MD

3923 Waring Rd Ste A

Oceanside, CA 92056

(760) 724-8782

Provider ID: 41552

License: A61516

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

POWAY

92064

Zakko, Maram MD

15611 Pomerado Rd Ste 400

Poway, CA 92064

(858) 675-3150

Provider ID: 270028

License: A64346

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Armenian,

Chinese, Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92102

Hassanein, Tarek MD

995 Gateway Center Way Ste

105

San Diego, CA 92102

(619) 264-1934

Provider ID: 269557

License: A54452

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

French, German, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 88

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

accessibility indicators are not

present.

92120

Reddy, Ananthram MD

6699 Alvarado Rd Ste 2301

San Diego, CA 92120

(619) 229-1005

Provider ID: 34354

License: C52423

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Cambodian,

Hindi, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SANTEE

92071

Reddy, Ananthram MD

9456 Cuyamaca St Ste 102

Santee, CA 92071

(619) 588-4074

Provider ID: 69412

License: C52423

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Cambodian,

Hindi, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Geriatric Medicine

CHULA VISTA

91910

Gutierrez, Aireen MD

480 Fourth Ave Ste 202

Chula Vista, CA 91910

(619) 427-3361

Provider ID: 268646

License: A77031

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

POWAY

92064

Schwartz, Martin MD

15611 Pomerado Rd Ste 400

Poway, CA 92064

(858) 675-3135

Provider ID: 122531

License: G39185

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 89

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

SAN DIEGO

92129

Miller, Scott MD

9878 Carmel Mountain Rd Ste

B

San Diego, CA 92129

(858) 312-1440

Provider ID: 271539

License: G129295

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Hearing Aid Dealer / Supplier

CARLSBAD

92008

Davis, Kelle MA

1820 Marron Rd Ste 102

Carlsbad, CA 92008

(760) 434-0125

Provider ID: 268654

License: HA6083

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

CHULA VISTA

91910

Anderson, Elaine MA

310 Third Ave Ste C11

Chula Vista, CA 91910

(619) 426-0841

Provider ID: 268688

License: HA7100

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Davis, Kelle MA

310 Third Ave Ste C11

Chula Vista, CA 91910

(619) 426-0841

Provider ID: 268651

License: HA6083

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

CORONADO

92118

Davis, Kelle MA

801 Orange Ave

Coronado, CA 92118

(619) 437-8154

Provider ID: 268655

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 90

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

License: HA6083

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

EL CAJON

92021

Anderson, Elaine MA

1767 E Main St

El Cajon, CA 92021

(619) 440-6516

Provider ID: 268692

License: HA7100

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Dandurand, John MA

1767 E Main St

El Cajon, CA 92021

(619) 440-6516

Provider ID: 269780

License: HA2056

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Davis, Kelle MA

1767 E Main St

El Cajon, CA 92021

(619) 440-6516

Provider ID: 268650

License: HA6083

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ESCONDIDO

92025

Anderson, Elaine MA

330 W Felicita Ave Ste A4

Escondido, CA 92025

(760) 489-1323

Provider ID: 268690

License: HA7100

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 91

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Dandurand, John MA

330 W Felicita Ave Ste A4

Escondido, CA 92025

(760) 489-1323

Provider ID: 269783

License: HA2056

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA MESA

91942

Anderson, Elaine MA

5565 Grossmont Center Dr

La Mesa, CA 91942

(619) 589-5414

Provider ID: 268693

License: HA7100

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Dandurand, John MA

5565 Grossmont Center Dr

La Mesa, CA 91942

(619) 589-5414

Provider ID: 269782

License: HA2056

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92120

Anderson, Elaine MA

6367 Alvarado Ct Ste 101

San Diego, CA 92120

(619) 583-7002

Provider ID: 268689

License: HA7100

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Dandurand, John MA

6367 Alvarado Ct

San Diego, CA 92120

(858) 259-4182

Provider ID: 269781

License: HA2056

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 92

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Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Davis, Kelle MA

6367 Alvarado Ct Ste 101

San Diego, CA 92120

(619) 583-7002

Provider ID: 268652

License: HA6083

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92123

Anderson, Elaine MA

9340 Clairemont Mesa Blvd Ste

D

San Diego, CA 92123

(858) 278-9911

Provider ID: 268691

License: HA7100

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Davis, Kelle MA

9340 Clairemont Mesa Blvd Ste

D

San Diego, CA 92123

(858) 278-9911

Provider ID: 268653

License: HA6083

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SOLANA BEACH

92075

Dandurand, John MA

740 Lomas Santa Fe Dr Ste 110

Solana Beach, CA 92075

(858) 259-4182

Provider ID: 269779

License: HA2056

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Hematology / Oncology

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 93

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ENCINITAS

92024

Bessudo, Alberto MD

326 Santa Fe Dr Ste 105

Encinitas, CA 92024

(760) 452-3340

Provider ID: 278508

License: A50309

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Hebrew,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Flores, Edna MD

477 N El Camino Real Ste D200

Encinitas, CA 92024

(760) 452-3440

Provider ID: 256367

License: A114373

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Sullivan, Jessica DO

477 N El Camino Real Ste D200

Encinitas, CA 92024

(760) 452-3340

Provider ID: 243484

License: 20A16273

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA JOLLA

92037

Banerjee, Pushpendu MD

9850 Genesee Ave Ste 560

La Jolla, CA 92037

(858) 552-1410

Provider ID: 257619

License: A69490

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Hindi

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Flores, Edna MD

9850 Genesee Ave Ste 830

La Jolla, CA 92037

(858) 552-1410

Provider ID: 256366

License: A114373

Credentials and/or board

certification: No

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 94

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Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA MESA

91942

Batra, Reema MD

5555 Grossmont Center Dr

La Mesa, CA 91942

(619) 644-3030

Provider ID: 58612

License: A118846

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Hindi,

Mandarin

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Bodkin, David MD

5555 Grossmont Center Dr

La Mesa, CA 91942

(619) 644-3030

Provider ID: 44084

License: G62107

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Arabic,

French, Hindi, Korean,

Mandarin, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Medic, Igor MD

5555 Grossmont Center Dr

La Mesa, CA 91942

(619) 644-3030

Provider ID: 119509

License: A146970

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Serbian, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Zu, Kai MD

5555 Grossmont Center Dr

La Mesa, CA 91942

(619) 644-3030

Provider ID: 43199

License: A74842

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Mandarin,

Spanish, Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 95

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92127

Bessudo, Alberto MD

16918 Dove Canyon Rd Ste

103

San Diego, CA 92127

(858) 649-5100

Provider ID: 256962

License: A50309

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Hebrew,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Eisenberg, Steven DO

16918 Dove Canyon Rd Ste

103

San Diego, CA 92127

(858) 649-5100

Provider ID: 242455

License: 20A8293

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Lamon, Joel MD

16918 Dove Canyon Rd Ste

103

San Diego, CA 92127

(858) 649-5100

Provider ID: 241036

License: G28164

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: French,

German, Spanish, Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN MARCOS

92069

Bessudo, Alberto MD

838 Nordahl Rd Ste 300

San Marcos, CA 92069

(760) 452-3340

Provider ID: 256963

License: A50309

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Hebrew,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 96

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

accessibility indicators are not

present.

Eisenberg, Steven DO

838 Nordahl Rd Ste 300

San Marcos, CA 92069

(760) 747-8935

Provider ID: 242456

License: 20A8293

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Kosmo, Michael MD

838 Nordahl Rd Ste 300

San Marcos, CA 92069

(760) 747-8935

Provider ID: 241034

License: G54074

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: French,

German, Spanish, Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Lamon, Joel MD

838 Nordahl Rd Ste 300

San Marcos, CA 92069

(760) 747-8935

Provider ID: 241037

License: G28164

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: French,

German, Spanish, Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Sullivan, Jessica DO

838 Nordahl Rd Ste 300

San Marcos, CA 92069

(760) 747-8935

Provider ID: 269662

License: 20A16273

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Hospice and Palliative

Medicine

Pasha, Sabiha MD

838 Nordahl Rd Ste 300

San Marcos, CA 92069

(760) 747-8935

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 97

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Provider ID: 276669

License: C50413

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: German,

Spanish, Urdu

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Infectious Disease

NATIONAL CITY

91950

Cabinian, Antonio MD

655 Euclid Ave Ste 209

National City, CA 91950

(619) 470-7000

Provider ID: 127991

License: A45959

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92103

Katsivas, Theodoros MD

4168 Front St

San Diego, CA 92103

(619) 543-3000

Provider ID: 269840

License: A78543

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: German,

Greek, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Internal Medicine Critical

Care Medicine

ESCONDIDO

92025

Hirsch, Gregory MD

488 E Valley Pkwy Ste 211

Escondido, CA 92025

(760) 489-1458

Provider ID: 269143

License: G40467

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Otoshi, James MD

488 E Valley Pkwy Ste 201

Escondido, CA 92025

(760) 489-1458

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 98

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Provider ID: 269095

License: G27763

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

POWAY

92064

Hirsch, Gregory MD

15611 Pomerado Rd Ste 400

Poway, CA 92064

(858) 675-3100

Provider ID: 53775

License: G40467

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Internal Medicine

CHULA VISTA

91910

Argoud, Georges MD

340 Fourth Ave Ste 7a

Chula Vista, CA 91910

(619) 691-0388

Provider ID: 217421

License: G61898

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

91911

Narayanan, Meena MD

765 Medical Center Ct Ste 211

Chula Vista, CA 91911

(619) 616-2100

Provider ID: 247694

License: A113448

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ENCINITAS

92024

Dilauro, Steven MD

700 Garden View Ct Ste 102

Encinitas, CA 92024

(760) 783-0441

Provider ID: 66036

License: A104332

Credentials and/or board

certification: Yes

Accepting New Members: Yes

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 99

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Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Goldklang, Robert MD

700 Garden View Ct Ste 102

Encinitas, CA 92024

(760) 783-0441

Provider ID: 66037

License: G69237

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Lajoie, Adrianne MD

700 Garden View Ct Ste 102

Encinitas, CA 92024

(760) 783-0441

Provider ID: 65629

License: A84301

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ESCONDIDO

92025

Chelimilla, Haritha MD

735 E Ohio Ave Ste 204

Escondido, CA 92025

(760) 294-7600

Provider ID: 269204

License: A124727

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Hindi,

Telugu

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Gara, Naveen MD

661 E Pennsylvania Ave

Escondido, CA 92025

(760) 690-2800

Provider ID: 269145

License: A149265

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Hindi,

Telugu

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 100

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present. Hours: M-SA 9AM-5PM Malek, Mikhail MD

92029

Acheatel, Roger MD

1955 Citracado Pkwy Ste 300

Escondido, CA 92029

(760) 743-0546

Provider ID: 269351

License: G45947

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Chen, Andrew MD

1955 Citracado Pkwy Ste 300

Escondido, CA 92029

(760) 743-0546

Provider ID: 269314

License: A120866

Credentials and/or board

certification: No

Accepting New Members: Yes

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Lee, Young MD

1955 Citracado Pkwy Ste 300

Escondido, CA 92029

(760) 743-0546

Provider ID: 269316

License: A130275

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Korean

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

1955 Citracado Pkwy Ste 300

Escondido, CA 92029

(760) 743-0546

Provider ID: 269307

License: A50952

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA JOLLA

92037

Dilauro, Steven MD

9850 Genesee Ave Ste 440

La Jolla, CA 92037

(858) 373-0211

Provider ID: 269298

License: A104332

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 101

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PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Goldklang, Robert MD

9850 Genesee Ave Ste 440

La Jolla, CA 92037

(858) 373-0211

Provider ID: 269271

License: G69237

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Lajoie, Adrianne MD

9850 Genesee Ave Ste 440

La Jolla, CA 92037

(858) 373-0211

Provider ID: 269300

License: A84301

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Wallach, Sabina MD

9850 Genesee Ave Ste 400

La Jolla, CA 92037

(858) 558-8666

Provider ID: 269286

License: A34070

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: French,

Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

POWAY

92064

Acheatel, Roger MD

15611 Pomerado Rd Ste 580

Poway, CA 92064

(858) 592-2696

Provider ID: 272330

License: G45947

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 102

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Chen, Andrew MD

15611 Pomerado Rd Ste 400

Poway, CA 92064

(858) 592-2696

Provider ID: 269315

License: A120866

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92114

Narayanan, Meena MD

292 Euclid Ave Ste 210

San Diego, CA 92114

(619) 616-2100

Provider ID: 247695

License: A113448

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN MARCOS

92078

Narayanan, Meena MD

955 Boardwalk Ste 100

San Marcos, CA 92078

(760) 798-8855

Provider ID: 247696

License: A113448

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SOLANA BEACH

92075

Argoud, Georges MD

530 Lomas Santa Fe Dr Ste 8

Solana Beach, CA 92075

(858) 704-4151

Provider ID: 268581

License: G61898

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Interventional Cardiology

CHULA VISTA

91911

Carlson, Steven MD

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 103

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

751 Medical Center Ct Ste 211

Chula Vista, CA 91911

(619) 616-2100

Provider ID: 244812

License: A109957

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA MESA

91942

Taghizadeh, Behzad MD

8851 Center Dr Ste 405

La Mesa, CA 91942

(619) 582-2404

Provider ID: 269161

License: C56208

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92114

Carlson, Steven MD

292 Euclid Ave Ste 210

San Diego, CA 92114

(619) 616-2100

Provider ID: 244810

License: A109957

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN MARCOS

92078

Carlson, Steven MD

955 Boardwalk Ste 100

San Marcos, CA 92078

(760) 798-8855

Provider ID: 244811

License: A109957

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Neonatal / Perinatal Medicine

SAN DIEGO

92101

Farrell, Maureen MD

2017 1st Ave Ste 201

San Diego, CA 92101

(619) 881-4589

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 104

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Provider ID: 270157 is limited access or when Accepting New Members: Yes

License: A82843 accessibility indicators are not Hours: M-SA 9AM-5PM

Credentials and/or board present. PTA: No

certification: No Other Language: Spanish

Accepting New Members: Yes Cultural Competency: NR

Hours: M-SA 9AM-5PM Mody, Sheila MD Accessibility: B; Members

PTA: No 2017 1st Ave Ste 100 should call the provider’s

Cultural Competency: NR San Diego, CA 92101 office to discuss their

Accessibility: B; Members (619) 543-6777 accessibility needs when there

should call the provider’s Provider ID: 270296 is limited access or when

office to discuss their License: A117818 accessibility indicators are not

accessibility needs when there Credentials and/or board present.

is limited access or when certification: No

accessibility indicators are not Accepting New Members: Yes 92114 present. Hours: M-SA 9AM-5PM

PTA: No Culwell, Kelly MD

Cultural Competency: NR 220 Euclid Ave Ste 30

Marengo Barbick, Antoinette Accessibility: B; Members San Diego, CA 92114

MD should call the provider’s (916) 734-6925

2017 1st Ave Ste 301 office to discuss their Provider ID: 270475

San Diego, CA 92101 accessibility needs when there License: A76983

(619) 881-4500 is limited access or when Credentials and/or board

Provider ID: 271176 accessibility indicators are not certification: No

License: A87783 present. Accepting New Members: Yes

Credentials and/or board Hours: M-SA 9AM-5PM

certification: No PTA: No

Accepting New Members: Yes Robertson, Lauren MD Cultural Competency: NR

Hours: M-SA 9AM-5PM 2017 1st Ave Ste 100 Accessibility: B; Members

PTA: No San Diego, CA 92101 should call the provider’s

Cultural Competency: NR (858) 455-7520 office to discuss their

Accessibility: B; Members Provider ID: 271054 accessibility needs when there

should call the provider’s License: A109671 is limited access or when

office to discuss their Credentials and/or board accessibility indicators are not

accessibility needs when there certification: No present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 105

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Cassey, Lindsay DO

220 Euclid Ave Ste 30

San Diego, CA 92114

(209) 576-3526

Provider ID: 270421

License: 20A14218

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

VISTA

92084

Movahhedian, Hamid MD

1000 Vale Terrace Dr

Vista, CA 92084

(760) 631-5000

Provider ID: 246863

License: A49253

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Faroese,

Farsi

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Nephrology

CHULA VISTA

91910

Bedoya, Luis MD

340 4th Ave Ste 4

Chula Vista, CA 91910

(619) 427-1144

Provider ID: 39369

License: A51105

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Espinosa-melendez, Enrique

MD

480 4th Ave Ste 507

Chula Vista, CA 91910

(619) 477-7779

Provider ID: 121742

License: C42745

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: French,

Portuguese, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Horeish, Adam MD

340 4th Ave Ste 4

Chula Vista, CA 91910

(619) 427-1144

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 106

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Provider ID: 99947 should call the provider’s Provider ID: 31395

License: C56089 office to discuss their License: A90108

Credentials and/or board accessibility needs when there Credentials and/or board

certification: No is limited access or when certification: No

Accepting New Members: Yes accessibility indicators are not Accepting New Members: Yes

Hours: M-SA 9AM-5PM present. Hours: M-SA 9AM-5PM

PTA: No PTA: No

Other Language: Arabic, Other Language: Spanish

Spanish Lozada-pastorio, Elizabeth MD Cultural Competency: NR

Cultural Competency: NR 340 4th Ave Ste 4 Accessibility: B; Members

Accessibility: B; Members Chula Vista, CA 91910 should call the provider’s

should call the provider’s (619) 427-1144 office to discuss their

office to discuss their Provider ID: 268556 accessibility needs when there

accessibility needs when there License: A90108 is limited access or when

is limited access or when Credentials and/or board accessibility indicators are not

accessibility indicators are not certification: No present.

present. Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes Meyer, Jill MD

Khaing, Kathy MD Other Language: Spanish 340 4th Ave Ste 4

340 4th Ave Ste 4 Cultural Competency: NR Chula Vista, CA 91910

Chula Vista, CA 91910 Accessibility: B; Members (619) 427-1144

(619) 427-1144 should call the provider’s Provider ID: 268563

Provider ID: 205003 office to discuss their License: A95882

License: A127006 accessibility needs when there Credentials and/or board

Credentials and/or board is limited access or when certification: Yes

certification: No accessibility indicators are not Accepting New Members: Yes

Accepting New Members: Yes present. Hours: M-SA 9AM-5PM

Hours: M-SA 9AM-5PM PTA: Yes

PTA: No Other Language: Spanish

Other Language: Burmese, Lozada-pastorio, Elizabeth MD Cultural Competency: NR

Spanish 340 Fourth Ave Ste 14 Accessibility: B, W; Members

Cultural Competency: NR Chula Vista, CA 91910 should call the provider’s

Accessibility: B; Members (619) 427-1144 office to discuss their

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 107

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

accessibility needs when there Credentials and/or board accessibility indicators are not

is limited access or when certification: No present.

accessibility indicators are not Accepting New Members: Yes

present. Hours: M-SA 9AM-5PM

PTA: No Yuan, Henry MD

Other Language: Spanish 340 Fourth Ave Ste 4

Patel, Amar MD Cultural Competency: NR Chula Vista, CA 91910

340 Fourth Ave Ste 4 Accessibility: B; Members (619) 427-1144

Chula Vista, CA 91910 should call the provider’s Provider ID: 268551

(858) 810-8000 office to discuss their License: A120403

Provider ID: 245639 accessibility needs when there Credentials and/or board

License: A158295 is limited access or when certification: Yes

Credentials and/or board accessibility indicators are not Accepting New Members: Yes

certification: No present. Hours: M-SA 9AM-5PM

Accepting New Members: Yes PTA: No

Hours: M-SA 9AM-5PM Other Language: Chinese,

PTA: No Soltero, Ricardo MD Mandarin, Spanish

Other Language: Gujarati 340 4th Ave Ste 4 Cultural Competency: NR

Cultural Competency: NR Chula Vista, CA 91910 Accessibility: B; Members

Accessibility: B; Members (619) 427-1144 should call the provider’s

should call the provider’s Provider ID: 268490 office to discuss their

office to discuss their License: A68995 accessibility needs when there

accessibility needs when there Credentials and/or board is limited access or when

is limited access or when certification: Yes accessibility indicators are not

accessibility indicators are not Accepting New Members: Yes present.

present. Hours: M-SA 9AM-5PM Special Expertise: HIV/AIDS

PTA: Yes

Other Language: Spanish 91911 Soltero, Ricardo MD Cultural Competency: NR

340 Fourth Ave Ste 14 Accessibility: B; Members Meyer, Jill MD

Chula Vista, CA 91910 should call the provider’s 752 Medical Center Ct Ste 302

(619) 427-1144 office to discuss their Chula Vista, CA 91911

Provider ID: 26526 accessibility needs when there (619) 421-3361

License: A68995 is limited access or when Provider ID: 65487

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 108

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License: A95882 is limited access or when certification: No

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Soltero, Ricardo MD

752 Medical Center Ct Ste 302

Chula Vista, CA 91911

(619) 421-3361

Provider ID: 268491

License: A68995

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

accessibility indicators are not

present.

Videen, John MD

752 Medical Center Ct Ste 302

Chula Vista, CA 91911

(619) 421-3361

Provider ID: 65646

License: G59271

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Vyas, Dhwanil MD

752 Medical Center Ct Ste 302

Chula Vista, CA 91911

(619) 421-3361

Provider ID: 106551

License: A125364

Credentials and/or board

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Gujarati,

Hindi, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

CORONADO

92118

Davis, Jason MD

230 Prospect Pl Ste 340b

Coronado, CA 92118

(619) 299-2350

Provider ID: 270966

License: A100799

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 109

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ENCINITAS

92024

Boiskin, Mark MD

320 Santa Fe Dr Ste 212

Encinitas, CA 92024

(858) 558-8150

Provider ID: 273106

License: A52055

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Afrikaans,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Steer, Dylan MD

320 Santa Fe Dr Ste 212

Encinitas, CA 92024

(760) 509-1040

Provider ID: 272853

License: A65604

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Torosian, Karo DO

320 Santa Fe Dr Ste 212

Encinitas, CA 92024

(858) 558-8150

Provider ID: 272858

License: 20A12445

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Armenian,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ESCONDIDO

92025

Greenstein, Joshua MD

631 E Grand Ave

Escondido, CA 92025

(760) 294-1660

Provider ID: 53809

License: A68100

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Hebreo, Joseph MD

631 E Grand Ave

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 110

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Escondido, CA 92025 Other Language: Arabic Neyaz, Mohammed DO

(760) 294-1660 Cultural Competency: NR 631 E Grand Ave

Provider ID: 108435 Accessibility: B; Members Escondido, CA 92025

License: A93436 should call the provider’s (760) 294-1660

Credentials and/or board office to discuss their Provider ID: 108420

certification: Yes accessibility needs when there License: 20A13534

Accepting New Members: Yes is limited access or when Credentials and/or board

Hours: M-SA 9AM-5PM accessibility indicators are not certification: No

PTA: No present. Accepting New Members: Yes

Other Language: Spanish, Hours: M-SA 9AM-5PM

Tagalog PTA: No

Cultural Competency: NR Khawar, Osman MD Other Language: Hindi,

Accessibility: B; Members 631 E Grand Ave Spanish, Urdu

should call the provider’s Escondido, CA 92025 Cultural Competency: NR

office to discuss their (760) 294-1660 Accessibility: B; Members

accessibility needs when there Provider ID: 53715 should call the provider’s

is limited access or when License: A92165 office to discuss their

accessibility indicators are not Credentials and/or board accessibility needs when there

present. certification: No is limited access or when

Accepting New Members: Yes accessibility indicators are not

Hours: M-SA 9AM-5PM present.

Kayal, Anas MD PTA: No

Contract terminated as of Other Language: Spanish,

6/30/2021 Urdu Shapiro, Mark MD

631 E Grand Ave Cultural Competency: NR Contract terminated as of

Escondido, CA 92025 Accessibility: B; Members 8/31/2021

(760) 294-1660 should call the provider’s 631 E Grand Ave

Provider ID: 269211 office to discuss their Escondido, CA 92025

License: A112450 accessibility needs when there (760) 294-1660

Credentials and/or board is limited access or when Provider ID: 275625

certification: No accessibility indicators are not License: G65280

Accepting New Members: No present. Credentials and/or board

Hours: M-SA 9AM-5PM certification: No

PTA: No Accepting New Members: No

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 111

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Swahili

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Shapiro, Mark MD

Future Effective as of 9/1/2021

631 E Grand Ave

Escondido, CA 92025

(760) 294-1660

Provider ID: 275625

License: G65280

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Swahili

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA JOLLA

92037

Boiskin, Mark MD

9834 Genesee Ave Ste 312

La Jolla, CA 92037

(858) 558-8150

Provider ID: 40762

License: A52055

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Afrikaans,

Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Lakhera, Yogita MD

9834 Genesee Ave Ste 312

La Jolla, CA 92037

(858) 558-8150

Provider ID: 109353

License: A125173

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Hindi

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Steer, Dylan MD

9834 Genesee Ave Ste 312

La Jolla, CA 92037

(858) 558-8150

Provider ID: 31399

License: A65604

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 112

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

is limited access or when Provider ID: 43077 office to discuss their

accessibility indicators are not

present.

Torosian, Karo DO

9834 Genesee Ave Ste 312

La Jolla, CA 92037

(858) 558-8150

Provider ID: 269269

License: 20A12445

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Armenian,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA MESA

91942

Do, Luan MD

8851 Center Dr Ste 505

La Mesa, CA 91942

(619) 461-3880

License: A65161

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Fadda, George MD

8851 Center Dr Ste 505

La Mesa, CA 91942

(619) 461-3880

Provider ID: 26465

License: A44918

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

French

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Miller, Lucy MD

8851 Center Dr Ste 505

La Mesa, CA 91942

(619) 461-3880

Provider ID: 26595

License: A53843

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Japanese,

Portuguese, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Thompson, John MD

8851 Center Dr Ste 505

La Mesa, CA 91942

(619) 461-3880

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 113

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Provider ID: 24866

License: G83902

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

NATIONAL CITY

91950

Calderon Molina, Juan MD

655 Euclid Ave Ste 303

National City, CA 91950

(619) 585-4370

Provider ID: 109336

License: C143845

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: German,

Spanish, Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Maa Chip, Fharak MD

655 Euclid Ave Ste 303

National City, CA 91950

(619) 475-4900

Provider ID: 84000

License: A117604

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Sacamay, Tagumpay MD

655 Euclid Ave Ste 303

National City, CA 91950

(619) 475-4900

Provider ID: 26710

License: A62631

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish,

Tagalog

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

OCEANSIDE

92056

Barager, Richard MD

3300 Vista Way Ste B

Oceanside, CA 92056

(760) 967-9900

Provider ID: 65959

License: G52074

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 114

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Kharadjian, Talar MD

3300 Vista Way Ste B

Oceanside, CA 92056

(760) 967-9900

Provider ID: 279811

License: A161276

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Armenian

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Kyaw, Naing MD

3300 Vista Way

Oceanside, CA 92056

(760) 967-9900

Provider ID: 269374

License: A97469

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Burmese,

Chinese, Mandarin, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Matayoshi, Amy MD

3300 Vista Way Ste B

Oceanside, CA 92056

(760) 967-9900

Provider ID: 54126

License: A60790

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92102

Quevedo, Juan MD

995 Gateway Center Way Ste

207

San Diego, CA 92102

(619) 263-9729

Provider ID: 269998

License: A144881

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 115

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

PTA: No92103 Other Language: Spanish Nguyen, Viet MD

Baranski, Joel MD Cultural Competency: NR 4060 4th Ave Ste 220

4060 4th Ave Ste 220 Accessibility: B; Members San Diego, CA 92103

San Diego, CA 92103 should call the provider’s (619) 299-2350

(619) 299-2350 office to discuss their Provider ID: 270191

Provider ID: 31396 accessibility needs when there License: A149088

License: G67559 is limited access or when Credentials and/or board

Credentials and/or board accessibility indicators are not certification: No

certification: No present. Accepting New Members: Yes

Accepting New Members: Yes Hours: M-SA 9AM-5PM

Hours: M-SA 9AM-5PM PTA: No

PTA: Yes Hammes, John MD Cultural Competency: NR

Other Language: Spanish 4060 Fourth Ave Ste 220 Accessibility: B; Members

Cultural Competency: NR San Diego, CA 92103 should call the provider’s

Accessibility: B, W; Members (619) 299-2350 office to discuss their

should call the provider’s Provider ID: 76487 accessibility needs when there

office to discuss their License: G84351 is limited access or when

accessibility needs when there Credentials and/or board accessibility indicators are not

is limited access or when certification: No present.

accessibility indicators are not Accepting New Members: No

present. Hours: M-SA 9AM-5PM

PTA: No Thomas, Theodore MD

Other Language: French, Contract terminated as of

Davis, Jason MD Spanish 8/31/2021

4060 Fourth Ave Ste 220 Cultural Competency: NR 4060 4th Ave Ste 220

San Diego, CA 92103 Accessibility: B; Members San Diego, CA 92103

(619) 299-2350 should call the provider’s (619) 299-2350

Provider ID: 80404 office to discuss their Provider ID: 26486

License: A100799 accessibility needs when there License: G61681

Credentials and/or board is limited access or when Credentials and/or board

certification: No accessibility indicators are not certification: Yes

Accepting New Members: Yes present. Accepting New Members: No

Hours: M-SA 9AM-5PM Hours: M-SA 9AM-5PM

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 116

Page 139: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92115

Behrend, Terry MD

6402 El Cajon Blvd Ste 100

San Diego, CA 92115

(619) 582-4490

Provider ID: 87090

License: A75812

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Namazy, David MD

6402 El Cajon Blvd Ste 100

San Diego, CA 92115

(858) 810-8092

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

Provider ID: 258028

License: A74630

accessibility needs when there

is limited access or when

Credentials and/or board accessibility indicators are not

certification: No

Accepting New Members: Yes

present.

Hours: M-SA 9AM-5PM

PTA: No Boiskin, Mark MD

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

9610 Granite Ridge Dr Ste B

San Diego, CA 92123

(858) 810-8000

Provider ID: 269490

office to discuss their License: A52055

accessibility needs when there

is limited access or when

Credentials and/or board

certification: No

accessibility indicators are not

present.

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

92123

Behrend, Terry MD

7910 Frost St Ste 220

San Diego, CA 92123

(858) 637-4700

Provider ID: 244798

License: A75812

Other Language: Afrikaans,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

accessibility indicators are not

present.

PTA: No Chongkrairatanakul, Tepsiri

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 117

Page 140: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

MD Other Language: German, Faravardeh, Arman MD

8010 Frost St Ste 510 Spanish, Tagalog 8010 Frost St Ste 510

San Diego, CA 92123 Cultural Competency: NR San Diego, CA 92123

(858) 637-4700 Accessibility: B; Members (858) 637-4800

Provider ID: 269868 should call the provider’s Provider ID: 82852

License: C157995 office to discuss their License: A94375

Credentials and/or board accessibility needs when there Credentials and/or board

certification: No is limited access or when certification: No

Accepting New Members: Yes accessibility indicators are not Accepting New Members: Yes

Hours: M-SA 9AM-5PM present. Hours: M-SA 9AM-5PM

PTA: No PTA: No

Other Language: Thai Other Language: Farsi,

Cultural Competency: NR Davis, Jason MD Swedish

Accessibility: B; Members 7910 Frost St Ste 250 Cultural Competency: NR

should call the provider’s San Diego, CA 92123 Accessibility: B; Members

office to discuss their (858) 637-4800 should call the provider’s

accessibility needs when there Provider ID: 270967 office to discuss their

is limited access or when License: A100799 accessibility needs when there

accessibility indicators are not Credentials and/or board is limited access or when

present. certification: No accessibility indicators are not

Accepting New Members: Yes present.

Hours: M-SA 9AM-5PM

Calderon Molina, Juan MD PTA: No

9610 Granite Ridge Dr Ste B Other Language: Spanish Khaing, Kathy MD

San Diego, CA 92123 Cultural Competency: NR 8010 Frost St Ste 510

(619) 475-4900 Accessibility: B; Members San Diego, CA 92123

Provider ID: 270710 should call the provider’s (858) 637-4700

License: C143845 office to discuss their Provider ID: 205002

Credentials and/or board accessibility needs when there License: A127006

certification: No is limited access or when Credentials and/or board

Accepting New Members: Yes accessibility indicators are not certification: No

Hours: M-SA 9AM-5PM present. Accepting New Members: Yes

PTA: No Hours: M-SA 9AM-5PM

PTA: No

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 118

Page 141: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Other Language: Burmese, Cultural Competency: NR

Spanish Namazy, David MD Accessibility: B; Members

Cultural Competency: NR 7910 Frost St Ste 220 should call the provider’s

Accessibility: B; Members San Diego, CA 92123 office to discuss their

should call the provider’s (858) 637-4700 accessibility needs when there

office to discuss their Provider ID: 258027 is limited access or when

accessibility needs when there License: A74630 accessibility indicators are not

is limited access or when Credentials and/or board present.

accessibility indicators are not certification: Yes

present. Accepting New Members: Yes

Hours: M-SA 9AM-5PM Shapiro, Mark MD

PTA: No Contract terminated as of

Lund, Guy MD Other Language: Spanish 8/31/2021

8010 Frost St Ste 510 Cultural Competency: NR 9610 Granite Ridge Dr Ste B

San Diego, CA 92123 Accessibility: B; Members San Diego, CA 92123

(858) 637-4700 should call the provider’s (858) 810-8000

Provider ID: 87088 office to discuss their Provider ID: 270972

License: A68839 accessibility needs when there License: G65280

Credentials and/or board is limited access or when Credentials and/or board

certification: No accessibility indicators are not certification: No

Accepting New Members: Yes present. Accepting New Members: No

Hours: M-SA 9AM-5PM Hours: M-SA 9AM-5PM

PTA: No PTA: No

Other Language: Slovak, Patel, Bijal MD Other Language: Spanish,

Spanish 8010 Frost St Ste 510 Swahili

Cultural Competency: NR San Diego, CA 92123 Cultural Competency: NR

Accessibility: B; Members (858) 637-4800 Accessibility: B; Members

should call the provider’s Provider ID: 34506 should call the provider’s

office to discuss their License: A74638 office to discuss their

accessibility needs when there Credentials and/or board accessibility needs when there

is limited access or when certification: No is limited access or when

accessibility indicators are not Accepting New Members: Yes accessibility indicators are not

present. Hours: M-SA 9AM-5PM present.

PTA: No

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 119

Page 142: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Steinberg, Steven MD

7910 Frost St Ste 250

San Diego, CA 92123

(858) 637-4800

Provider ID: 270031

License: G17843

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Steinberg, Steven MD

8010 Frost St Ste 510

San Diego, CA 92123

(858) 637-4700

Provider ID: 87140

License: G17843

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Neurology

CARLSBAD

92011

Blumenfeld, Andrew MD

6010 Hidden Valley Rd Ste 200

Carlsbad, CA 92011

(760) 631-3000

Provider ID: 25914

License: A47863

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Choudry, Bilal MD

6010 Hidden Valley Rd Ste 200

Carlsbad, CA 92011

(760) 631-3000

Provider ID: 85292

License: A114607

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Urdu

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Delaney, Michael MD

6010 Hidden Valley Rd Ste 200

Carlsbad, CA 92011

(760) 631-6000

Provider ID: 269103

License: C146015

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 120

Page 143: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

PTA: No 6010 Hidden Valley Rd Ste 200 Accessibility: B; Members

Other Language: Spanish Carlsbad, CA 92011 should call the provider’s

Cultural Competency: NR (760) 631-3000 office to discuss their

Accessibility: B; Members Provider ID: 65471 accessibility needs when there

should call the provider’s License: G43493 is limited access or when

office to discuss their Credentials and/or board accessibility indicators are not

accessibility needs when there certification: Yes present.

is limited access or when Accepting New Members: Yes

accessibility indicators are not Hours: M-SA 9AM-5PM

present. PTA: No Gualberto, Gary MD

Other Language: Spanish 6010 Hidden Valley Rd Ste 200

Cultural Competency: NR Carlsbad, CA 92011

Desadier, Laura DO Accessibility: B; Members (760) 631-3000

6010 Hidden Valley Rd Ste 200 should call the provider’s Provider ID: 103158

Carlsbad, CA 92011 office to discuss their License: C138319

(760) 631-3000 accessibility needs when there Credentials and/or board

Provider ID: 242451 is limited access or when certification: No

License: 20A14045 accessibility indicators are not Accepting New Members: Yes

Credentials and/or board present. Hours: M-SA 9AM-5PM

certification: No PTA: No

Accepting New Members: Yes Other Language: Spanish

Hours: M-SA 9AM-5PM Gokaldas, Reshma MD Cultural Competency: NR

PTA: No 6010 Hidden Valley Rd Ste 200 Accessibility: B; Members

Cultural Competency: NR Carlsbad, CA 92011 should call the provider’s

Accessibility: B; Members (760) 631-3000 office to discuss their

should call the provider’s Provider ID: 108460 accessibility needs when there

office to discuss their License: A138459 is limited access or when

accessibility needs when there Credentials and/or board accessibility indicators are not

is limited access or when certification: No present.

accessibility indicators are not Accepting New Members: Yes

present. Hours: M-SA 9AM-5PM

PTA: No Lobatz, Michael MD

Other Language: Spanish 6010 Hidden Valley Rd Ste 200

Frishberg, Benjamin MD Cultural Competency: NR Carlsbad, CA 92011

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 121

Page 144: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

(760) 631-3000 office to discuss their License: 20A11494

Provider ID: 52424 accessibility needs when there Credentials and/or board

License: G38353 is limited access or when certification: No

Credentials and/or board accessibility indicators are not Accepting New Members: Yes

certification: No present. Hours: M-SA 9AM-5PM

Accepting New Members: Yes PTA: No

Hours: M-SA 9AM-5PM Other Language: Spanish

PTA: No Lawler, Abigail MD Cultural Competency: NR

Other Language: Hebrew, 6010 Hidden Valley Rd Ste 200 Accessibility: B; Members

Spanish Carlsbad, CA 92011 should call the provider’s

Cultural Competency: NR (760) 631-3000 office to discuss their

Accessibility: B; Members Provider ID: 124983 accessibility needs when there

should call the provider’s License: A152080 is limited access or when

office to discuss their Credentials and/or board accessibility indicators are not

accessibility needs when there certification: No present.

is limited access or when Accepting New Members: Yes

accessibility indicators are not Hours: M-SA 9AM-5PM

present. PTA: No Oh, Irene MD

Other Language: Spanish 6010 Hidden Valley Rd Ste 200

Cultural Competency: NR Carlsbad, CA 92011

Lane, Richard MD Accessibility: B; Members (760) 631-3000

6010 Hidden Valley Rd Ste 200 should call the provider’s Provider ID: 52430

Carlsbad, CA 92011 office to discuss their License: A106450

(760) 631-3000 accessibility needs when there Credentials and/or board

Provider ID: 276889 is limited access or when certification: No

License: A160001 accessibility indicators are not Accepting New Members: Yes

Credentials and/or board present. Hours: M-SA 9AM-5PM

certification: No PTA: No

Accepting New Members: Yes Other Language: Spanish

Hours: M-SA 9AM-5PM Nielsen, Amy DO Cultural Competency: NR

PTA: No 6010 Hidden Valley Rd Ste 200 Accessibility: B; Members

Cultural Competency: NR Carlsbad, CA 92011 should call the provider’s

Accessibility: B; Members (760) 631-3000 office to discuss their

should call the provider’s Provider ID: 74893 accessibility needs when there

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 122

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

is limited access or when

accessibility indicators are not

present.

Omuro, Arthur DO

6010 Hidden Valley Rd Ste 200

Carlsbad, CA 92011

(760) 631-3000

Provider ID: 276907

License: 20A15164

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Paduga, Remia MD

6010 Hidden Valley Rd Ste 200

Carlsbad, CA 92011

(760) 631-3000

Provider ID: 57065

License: A113451

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Pham, Alise DO

6010 Hidden Valley Rd Ste 200

Carlsbad, CA 92011

(760) 631-3000

Provider ID: 276490

License: 20A18259

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Quesnell, Tara DO

6010 Hidden Valley Rd Ste 200

Carlsbad, CA 92011

(760) 631-3000

Provider ID: 109393

License: 20A13609

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Rosenberg, Jay MD

6010 Hidden Valley Rd Ste 200

Carlsbad, CA 92011

(760) 631-3000

Provider ID: 31935

License: G17059

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 123

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

PTA: No Sahagian, Gregory MD Cultural Competency: NR

Other Language: Spanish 6010 Hidden Valley Rd Ste 200 Accessibility: B; Members

Cultural Competency: NR Carlsbad, CA 92011 should call the provider’s

Accessibility: B; Members (760) 631-3000 office to discuss their

should call the provider’s Provider ID: 65995 accessibility needs when there

office to discuss their License: A62263 is limited access or when

accessibility needs when there Credentials and/or board accessibility indicators are not

is limited access or when certification: No present.

accessibility indicators are not Accepting New Members: Yes

present. Hours: M-SA 9AM-5PM

PTA: No Wang, Anchi MD

Other Language: Spanish 6010 Hidden Valley Rd Ste 200

Sadoff, Mark MD Cultural Competency: NR Carlsbad, CA 92011

6010 Hidden Valley Rd Ste 200 Accessibility: B; Members (760) 631-3000

Carlsbad, CA 92011 should call the provider’s Provider ID: 52465

(760) 631-3000 office to discuss their License: A79381

Provider ID: 40012 accessibility needs when there Credentials and/or board

License: G42818 is limited access or when certification: No

Credentials and/or board accessibility indicators are not Accepting New Members: Yes

certification: Yes present. Hours: M-SA 9AM-5PM

Accepting New Members: Yes PTA: No

Hours: M-SA 9AM-5PM Other Language: Mandarin,

PTA: No Schim, Jack MD Spanish

Other Language: Spanish 6010 Hidden Valley Rd Ste 200 Cultural Competency: NR

Cultural Competency: NR Carlsbad, CA 92011 Accessibility: B; Members

Accessibility: B; Members (760) 631-3000 should call the provider’s

should call the provider’s Provider ID: 52446 office to discuss their

office to discuss their License: G48807 accessibility needs when there

accessibility needs when there Credentials and/or board is limited access or when

is limited access or when certification: Yes accessibility indicators are not

accessibility indicators are not Accepting New Members: Yes present.

present. Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish Wang, Chunyang MD

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 124

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

6010 Hidden Valley Rd Ste 200

Carlsbad, CA 92011

(760) 631-3000

Provider ID: 84398

License: A105660

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Mandarin,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

CHULA VISTA

91911

Mohammad, Ahmad Shah MD

750 Medical Center Ct Ste 6

Chula Vista, CA 91911

(619) 337-7900

Provider ID: 127244

License: A98831

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Farsi, French, German,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ESCONDIDO

92029

Delaney, Michael MD

1955 Citracado Pkwy Ste 102

Escondido, CA 92029

(760) 631-3000

Provider ID: 269104

License: C146015

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Frishberg, Benjamin MD

1955 Citracado Pkwy Ste 102

Escondido, CA 92029

(760) 631-3000

Provider ID: 76522

License: G43493

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Lawler, Abigail MD

1955 Citracado Pkwy Ste 102

Escondido, CA 92029

(760) 631-3000

Provider ID: 125131

License: A152080

Credentials and/or board

certification: No

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 125

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Accepting New Members: Yes PTA: No

Hours: M-SA 9AM-5PM Other Language: Spanish

PTA: No Quesnell, Tara DO Cultural Competency: NR

Other Language: Spanish 1955 Citracado Pkwy Ste 102 Accessibility: B; Members

Cultural Competency: NR Escondido, CA 92029 should call the provider’s

Accessibility: B; Members (760) 631-3000 office to discuss their

should call the provider’s Provider ID: 109398 accessibility needs when there

office to discuss their License: 20A13609 is limited access or when

accessibility needs when there Credentials and/or board accessibility indicators are not

is limited access or when certification: No present.

accessibility indicators are not Accepting New Members: Yes

present. Hours: M-SA 9AM-5PM

PTA: No Wang, Anchi MD

Other Language: Spanish 1955 Citracado Pkwy Ste 102

Oh, Irene MD Cultural Competency: NR Escondido, CA 92029

1955 Citracado Pkwy Ste 102 Accessibility: B; Members (760) 631-3000

Escondido, CA 92029 should call the provider’s Provider ID: 99281

(760) 631-3000 office to discuss their License: A79381

Provider ID: 76600 accessibility needs when there Credentials and/or board

License: A106450 is limited access or when certification: No

Credentials and/or board accessibility indicators are not Accepting New Members: Yes

certification: No present. Hours: M-SA 9AM-5PM

Accepting New Members: Yes PTA: No

Hours: M-SA 9AM-5PM Other Language: Mandarin,

PTA: No Rosenberg, Jay MD Spanish

Other Language: Spanish 1955 Citracado Pkwy Ste 102 Cultural Competency: NR

Cultural Competency: NR Escondido, CA 92029 Accessibility: B; Members

Accessibility: B; Members (760) 631-3000 should call the provider’s

should call the provider’s Provider ID: 94232 office to discuss their

office to discuss their License: G17059 accessibility needs when there

accessibility needs when there Credentials and/or board is limited access or when

is limited access or when certification: No accessibility indicators are not

accessibility indicators are not Accepting New Members: Yes present.

present. Hours: M-SA 9AM-5PM

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 126

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Wang, Chunyang MD

1955 Citracado Pkwy Ste 102

Escondido, CA 92029

(760) 631-3000

Provider ID: 84403

License: A105660

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Mandarin,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA JOLLA

92037

Blumenfeld, Andrew MD

9850 Genesee Ave Ste 505

La Jolla, CA 92037

(760) 631-3000

Provider ID: 277503

License: A47863

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Nielsen, Amy DO

9850 Genesee Ave Ste 530

La Jolla, CA 92037

(760) 631-3000

Provider ID: 277009

License: 20A11494

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA MESA

91942

Mohammad, Ahmad Shah MD

8851 Center Dr Ste 307

La Mesa, CA 91942

(619) 337-7900

Provider ID: 39868

License: A98831

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Arabic,

Farsi, French, German,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

POWAY

92064

Blumenfeld, Andrew MD

15611 Pomerado Rd Ste 505

Poway, CA 92064

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 127

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

(760) 631-3000

Provider ID: 268086

License: A47863

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Delaney, Michael MD

15721 Pomerado Rd

Poway, CA 92064

(760) 631-3000

Provider ID: 269105

License: C146015

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Delaney, Michael MD

15611 Pomerado Rd Ste 505

Poway, CA 92064

(760) 631-3000

Provider ID: 272331

License: C146015

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Wang, Chunyang MD

15611 Pomerado Rd Ste 505

Poway, CA 92064

(760) 631-3000

Provider ID: 268120

License: A105660

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Mandarin,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92120

Khamishon, Boris MD

6699 Alvarado Rd Ste 2301

San Diego, CA 92120

(619) 582-2595

Provider ID: 269923

License: A56165

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B, W; Members

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 128

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92123

Shapiro, Mark MD

Future Effective as of 9/1/2021

9610 Granite Ridge Dr Ste B

San Diego, CA 92123

(858) 810-8000

Provider ID: 270972

License: G65280

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Swahili

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92128

Schumann, Richard MD

16776 Bernardo Center Dr Ste

209

San Diego, CA 92128

(858) 675-1112

Provider ID: 269967

License: A62324

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Nuclear Medicine

92123

Evans, David MD

3444 Kearny Villa Rd Ste 201

San Diego, CA 92123

(858) 430-1101

Provider ID: 129554

License: G55686

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Kipper, Michael MD

5395 Ruffin Rd Ste 202

San Diego, CA 92123

(858) 569-7899

Provider ID: 119551

License: A24718

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Obstetrics / Gynecology

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 129

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

CHULA VISTA

91911

Anguiano, Francisco MD

765 Medical Center Ct Ste 209

Chula Vista, CA 91911

(619) 427-8892

Provider ID: 268797

License: G61584

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Atiga, Schubert MD

752 Medical Center Ct Ste 106

Chula Vista, CA 91911

(619) 482-8406

Provider ID: 268953

License: G53756

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish,

Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

EL CAJON

92021

Bukowski, Kyle MD

1685 E Main St Ste 301

El Cajon, CA 92021

(310) 825-9945

Provider ID: 269037

License: A133994

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ESCONDIDO

92025

Chiarappa, Ashley MD

488 E Valley Pkwy Ste 310

Escondido, CA 92025

(760) 745-7060

Provider ID: 269149

License: A164036

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Cizmar, Branislav MD

488 E Valley Pkwy Ste 311

Escondido, CA 92025

(760) 233-1896

Provider ID: 54052

License: A80606

Credentials and/or board

certification: No

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 130

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Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Italian,

Slovak, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Cizek, Stephanie MD

347 W Mission Ave

Escondido, CA 92025

(415) 833-9183

Provider ID: 269235

License: A135224

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Hinshaw, Paul DO

426 N Date St

Escondido, CA 92025

(760) 690-5900

Provider ID: 269223

License: 20A13379

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA JOLLA

92037

Alvarado, Jorge MD

9300 Campus Point Dr

La Jolla, CA 92037

(858) 657-7000

Provider ID: 269564

License: A139473

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Su, Hui Chun MD

9350 Campus Point Dr Ste Llc

La Jolla, CA 92037

(858) 657-8745

Provider ID: 269338

License: A110340

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Mandarin

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

NATIONAL CITY

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 131

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certification: No present.91950

Del Rosario, Gelen MD

502 Euclid Ave Ste 300

National City, CA 91950

(619) 475-1261

Provider ID: 269247

License: A113471

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92103

Frugoni, Gina MD

4168 Front St

San Diego, CA 92103

(619) 543-7878

Provider ID: 270056

License: A99646

Credentials and/or board

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Herrero, Tiffany MD

200 W Arbor Dr

San Diego, CA 92103

(650) 243-7942

Provider ID: 270001

License: A119846

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Mandarin,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

92108

Nguyen, Son MD

1075 Camino Del Rio S

San Diego, CA 92108

(619) 881-4500

Provider ID: 271018

License: G63695

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Priver, David MD

1075 Camino Del Rio S

San Diego, CA 92108

(619) 280-4213

Provider ID: 271005

License: C38171

Credentials and/or board

certification: No

Accepting New Members: Yes

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 132

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Hours: M-SA 9AM-5PM

PTA: No

Other Language: French,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92114

Moran, Thomas MD

220 Euclid Ave Ste 30

San Diego, CA 92114

(619) 881-4500

Provider ID: 270953

License: G59541

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92123

Mansour, Anmar MD

7695 Cardinal Ct Ste 370

San Diego, CA 92123

(858) 277-1599

Provider ID: 204717

License: A92470

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Arabic,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Occupational Therapist

CHULA VISTA

91910

Morris, Sheila OT

1020 Tierra Del Rey Ste A-1

Chula Vista, CA 91910

(619) 585-7104

Provider ID: 268926

License: OT15057

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92121

Manecke, Kristen OT

9333 Genesee Ave Ste 350b

San Diego, CA 92121

(858) 455-6460

Provider ID: 269897

License: OT2537

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 133

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accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Oncology Medical

ENCINITAS

92024

Frakes, Laurie MD

477 N El Camino Real Ste C204

Encinitas, CA 92024

(760) 452-3340

Provider ID: 269133

License: A52663

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Mcclay, Edward MD

477 N El Camino Real Ste D200

Encinitas, CA 92024

(760) 452-3340

Provider ID: 243933

License: G64594

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA JOLLA

92037

Sinclair, James MD

9850 Genesee Ave Ste 560

La Jolla, CA 92037

(858) 552-1410

Provider ID: 257002

License: G48926

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92127

Frakes, Laurie MD

16918 Dove Canyon Rd Ste

103

San Diego, CA 92127

(858) 649-5100

Provider ID: 241857

License: A52663

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN MARCOS

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 134

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

PTA: No92069 91901

Frakes, Laurie MD

838 Nordahl Rd Ste 300

San Marcos, CA 92069

(760) 747-8935

Provider ID: 269134

License: A52663

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Mcclay, Edward MD

838 Nordahl Rd Ste 300

San Marcos, CA 92069

(760) 747-8935

Provider ID: 243932

License: G64594

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Sinclair, James MD

838 Nordahl Rd Ste 300

San Marcos, CA 92069

(760) 474-8935

Provider ID: 257003

License: G48926

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Ophthalmology

ALPINE

Binder, Nicholas MD

1620 Alpine Blvd Ste 117

Alpine, CA 91901

(619) 445-2687

Provider ID: 268753

License: A124698

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Chang, Tom MD

1620 Alpine Blvd Ste 117

Alpine, CA 91901

(800) 897-2020

Provider ID: 270362

License: A69909

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 135

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Other Language: Arabic, accessibility needs when there Provider ID: 268803

Armenian, Cantonese, is limited access or when License: A114976

Croatian, Korean, Mandarin, accessibility indicators are not Credentials and/or board

Spanish, Tagalog present. certification: No

Cultural Competency: NR Accepting New Members: Yes

Accessibility: B; Members Hours: M-SA 9AM-5PM

should call the provider’s Patel, Gitane MD PTA: No

office to discuss their 1620 Alpine Blvd Ste 117 Other Language: Gujarati,

accessibility needs when there Alpine, CA 91901 Hindi, Spanish, Tagalog,

is limited access or when (800) 898-2020 Vietnamese

accessibility indicators are not Provider ID: 268739 Cultural Competency: NR

present. License: A108603 Accessibility: B; Members

Special Expertise: Deafness or Credentials and/or board should call the provider’s

Hard-of-Hearing, Co-occuring certification: No office to discuss their

Disorders Accepting New Members: Yes accessibility needs when there

Hours: M-SA 9AM-5PM is limited access or when

PTA: Yes accessibility indicators are not

Miller, Douglas MD Other Language: Arabic, present.

1620 Alpine Blvd Ste 117 Gujarati, Spanish, Tagalog,

Alpine, CA 91901 Vietnamese

(619) 445-2687 Cultural Competency: NR Prabhu, Sujata MD

Provider ID: 268957 Accessibility: B; Members 1620 Alpine Blvd Ste 117

License: G52627 should call the provider’s Alpine, CA 91901

Credentials and/or board office to discuss their (619) 445-2687

certification: No accessibility needs when there Provider ID: 268918

Accepting New Members: Yes is limited access or when License: A115965

Hours: M-SA 9AM-5PM accessibility indicators are not Credentials and/or board

PTA: No present. certification: No

Other Language: Spanish, Accepting New Members: Yes

Tagalog, Vietnamese Hours: M-SA 9AM-5PM

Cultural Competency: NR Patel, Sarjan MD PTA: No

Accessibility: B; Members 1620 Alpine Blvd Ste 117 Other Language: Spanish,

should call the provider’s Alpine, CA 91901 Tagalog, Telugu, Vietnamese

office to discuss their (619) 445-2687 Cultural Competency: NR

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 136

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Wainess, Reid MD

1620 Alpine Blvd Ste 117

Alpine, CA 91901

(800) 898-2020

Provider ID: 254761

License: A108766

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Armenian,

Cantonese, Hebrew,

Mandarin, Spanish,

Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

CHULA VISTA

91910

Bryant, Duane MD

342 F St

Chula Vista, CA 91910

(619) 422-1471

Provider ID: 244753

License: C155562

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Castillejos-rios, David MD

342 F St

Chula Vista, CA 91910

(619) 422-1471

Provider ID: 268782

License: A44482

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Castillejos, Maria MD

342 F St

Chula Vista, CA 91910

(619) 422-1471

Provider ID: 268747

License: A37652

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Goldman, Ronald MD

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 137

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

480 4th Ave Ste 201 Cultural Competency: NR

Chula Vista, CA 91910 Accessibility: B; Members

(619) 427-3355 should call the provider’s

Provider ID: 26488 office to discuss their

License: C27512 accessibility needs when there

Credentials and/or board is limited access or when

certification: Yes accessibility indicators are not

Accepting New Members: Yes present.

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish, Vadoothker, Saujanya MD

Tagalog 480 4th Ave Ste 201

Cultural Competency: NR Chula Vista, CA 91910

Accessibility: B; Members (619) 427-3355

should call the provider’s Provider ID: 268635

office to discuss their License: A156489

accessibility needs when there Credentials and/or board

is limited access or when certification: No

accessibility indicators are not Accepting New Members: Yes

present. Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Scher, Barry MD Tagalog

480 Fourth Ave Ste 201 Cultural Competency: NR

Chula Vista, CA 91910 Accessibility: B; Members

(619) 427-3355 should call the provider’s

Provider ID: 268828 office to discuss their

License: G23827 accessibility needs when there

Credentials and/or board is limited access or when

certification: No accessibility indicators are not

Accepting New Members: Yes present.

Hours: M-SA 9AM-5PM

PTA: No 91911 Other Language: Spanish

Carraby, Arnett MD

835 Third Ave Ste A

Chula Vista, CA 91911

(619) 425-7755

Provider ID: 103061

License: G47836

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Tagalog, Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Chavez, Cesar MD

835 Third Ave Ste A

Chula Vista, CA 91911

(619) 425-7755

Provider ID: 268776

License: G51615

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 138

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Other Language: Spanish PTA: No

Cultural Competency: NR Echegoyen, Julio MD Other Language: Farsi,

Accessibility: B; Members 835 3rd Ave Ste A Spanish

should call the provider’s Chula Vista, CA 91911 Cultural Competency: NR

office to discuss their (619) 425-7755 Accessibility: B; Members

accessibility needs when there Provider ID: 257137 should call the provider’s

is limited access or when License: A121431 office to discuss their

accessibility indicators are not Credentials and/or board accessibility needs when there

present. certification: Yes is limited access or when

Accepting New Members: Yes accessibility indicators are not

Hours: M-SA 9AM-5PM present.

Delengocky, Tayson DO PTA: No

835 3rd Ave Ste A Other Language: Spanish,

Chula Vista, CA 91911 Tagalog Mani, Hamid MD

(619) 425-7755 Cultural Competency: NR 835 3rd Ave Ste A

Provider ID: 78153 Accessibility: B; Members Chula Vista, CA 91911

License: 20A12784 should call the provider’s (619) 425-7755

Credentials and/or board office to discuss their Provider ID: 269229

certification: Yes accessibility needs when there License: A40472

Accepting New Members: Yes is limited access or when Credentials and/or board

Hours: M-SA 9AM-5PM accessibility indicators are not certification: No

PTA: Yes present. Accepting New Members: Yes

Other Language: Farsi, Hours: M-SA 9AM-5PM

French, Spanish, Tagalog, PTA: No

Vietnamese Khandan, Sara MD Other Language: Arabic,

Cultural Competency: NR 835 Third Ave Ste A Farsi, Spanish

Accessibility: B; Members Chula Vista, CA 91911 Cultural Competency: NR

should call the provider’s (619) 425-7755 Accessibility: B; Members

office to discuss their Provider ID: 268580 should call the provider’s

accessibility needs when there License: A155828 office to discuss their

is limited access or when Credentials and/or board accessibility needs when there

accessibility indicators are not certification: No is limited access or when

present. Accepting New Members: Yes accessibility indicators are not

Hours: M-SA 9AM-5PM present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 139

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Hours: M-SA 9AM-5PM

PTA: Yes

Mani, Majid MD Other Language: Arabic, Papastergiou, Georgios MD

835 3rd Ave Ste A Faroese, Farsi, Spanish 835 3rd Ave Ste A

Chula Vista, CA 91911 Cultural Competency: NR Chula Vista, CA 91911

(619) 425-7755 Accessibility: B; Members (619) 425-7755

Provider ID: 269193 should call the provider’s Provider ID: 269189

License: A60640 office to discuss their License: A127706

Credentials and/or board accessibility needs when there Credentials and/or board

certification: No is limited access or when certification: Yes

Accepting New Members: Yes accessibility indicators are not Accepting New Members: Yes

Hours: M-SA 9AM-5PM present. Hours: M-SA 9AM-5PM

PTA: No PTA: Yes

Other Language: Farsi, Other Language: Arabic,

Spanish Moss, Jason MD Farsi, French, Greek, Italian,

Cultural Competency: NR 835 Third Ave Ste A Spanish

Accessibility: B; Members Chula Vista, CA 91911 Cultural Competency: NR

should call the provider’s (619) 425-7755 Accessibility: B; Members

office to discuss their Provider ID: 106478 should call the provider’s

accessibility needs when there License: A130529 office to discuss their

is limited access or when Credentials and/or board accessibility needs when there

accessibility indicators are not certification: No is limited access or when

present. Accepting New Members: Yes accessibility indicators are not

Hours: M-SA 9AM-5PM present.

PTA: No

Mani, Nasrin MD Other Language: Spanish

835 3rd Ave Ste A Cultural Competency: NR Pons, Mauricio MD

Chula Vista, CA 91911 Accessibility: B; Members 835 3rd Ave Ste A

(619) 425-7755 should call the provider’s Chula Vista, CA 91911

Provider ID: 269199 office to discuss their (619) 425-7755

License: A40473 accessibility needs when there Provider ID: 269242

Credentials and/or board is limited access or when License: A87650

certification: No accessibility indicators are not Credentials and/or board

Accepting New Members: Yes present. certification: No

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 140

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Peairs, James MD

835 Third Ave Ste A

Chula Vista, CA 91911

(619) 425-7755

Provider ID: 268818

License: A155296

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Rajsbaum, Martin MD

835 Third Ave Ste A

Chula Vista, CA 91911

(619) 425-7755

Provider ID: 268749

License: A42670

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Russian, Spanish, Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Sassani, Patrick MD

835 Third Ave Ste A

Chula Vista, CA 91911

(619) 425-7755

Provider ID: 269076

License: A150205

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Spanish, Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Scher, Barry MD

835 Third Ave Ste A

Chula Vista, CA 91911

(619) 425-7755

Provider ID: 268830

License: G23827

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 141

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

present. Accepting New Members: Yes present.

Skaf, Ayham MD

835 3rd Ave Ste A

Chula Vista, CA 91911

(619) 425-7755

Provider ID: 269074

License: A120584

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Stainer, Gregory MD

835 Third Ave Ste A

Chula Vista, CA 91911

(619) 425-7755

Provider ID: 272892

License: G41135

Credentials and/or board

certification: No

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

EL CAJON

92020

Binder, Nicholas MD

450 Fletcher Pkwy Ste 112

El Cajon, CA 92020

(619) 697-4600

Provider ID: 268752

License: A124698

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

Mcgraw, Joseph MD

450 Fletcher Pkwy Ste 112

El Cajon, CA 92020

(800) 898-2020

Provider ID: 269703

License: A155228

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Miller, Douglas MD

450 Fletcher Pkwy Ste 112

El Cajon, CA 92020

(800) 898-2020

Provider ID: 68144

License: G52627

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 142

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

PTA: No present. certification: No

Other Language: Spanish,

Tagalog, Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Patel, Gitane MD

450 Fletcher Pkwy Ste 112

El Cajon, CA 92020

(800) 898-2020

Provider ID: 268740

License: A108603

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Arabic,

Gujarati, Spanish, Tagalog,

Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

Patel, Sarjan MD

450 Fletcher Pkwy Ste 112

El Cajon, CA 92020

(800) 898-2020

Provider ID: 268799

License: A114976

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Gujarati,

Hindi, Spanish, Tagalog,

Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Prabhu, Sujata MD

450 Fletcher Pkwy Ste 112

El Cajon, CA 92020

(800) 898-2020

Provider ID: 268917

License: A115965

Credentials and/or board

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Tagalog, Telugu, Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ENCINITAS

92024

Mcgraw, Joseph MD

320 Santa Fe Dr Ste 104

Encinitas, CA 92024

(800) 898-2020

Provider ID: 269706

License: A155228

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 143

Page 166: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

is limited access or when

accessibility indicators are not

present.

Scotti, Frank MD

320 Santa Fe Dr Ste 104

Encinitas, CA 92024

(760) 943-7141

Provider ID: 255689

License: G40698

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish,

Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ESCONDIDO

92025

Binder, Nicholas MD

830 W Valley Pkwy Ste 300

Escondido, CA 92025

(800) 898-2020

Provider ID: 268756

License: A124698

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Mcgraw, Joseph MD

830 W Valley Pkwy Ste 300

Escondido, CA 92025

(800) 898-2020

Provider ID: 269705

License: A155228

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Miller, Douglas MD

830 W Valley Pkwy Ste 300

Escondido, CA 92025

(760) 743-5872

Provider ID: 268956

License: G52627

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Tagalog, Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Morrison-reyes, Joshua MD

830 W Valley Pkwy Ste 300

Escondido, CA 92025

(760) 743-5872

Provider ID: 269179

License: A125435

Credentials and/or board

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 144

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Armenian,

Cantonese, Indonesian,

Mandarin, Spanish, Tagalog,

Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Patel, Gitane MD

830 W Valley Pkwy Ste 300

Escondido, CA 92025

(760) 743-5872

Provider ID: 268741

License: A108603

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Gujarati, Spanish, Tagalog,

Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Patel, Sarjan MD

830 W Valley Pkwy Ste 300

Escondido, CA 92025

(800) 898-2020

Provider ID: 268802

License: A114976

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Gujarati,

Hindi, Spanish, Tagalog,

Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Prabhu, Sujata MD

830 W Valley Pkwy Ste 300

Escondido, CA 92025

(800) 898-2020

Provider ID: 268920

License: A115965

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Tagalog, Telugu, Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA JOLLA

92037

Binder, Nicholas MD

9850 Genesee Ave Ste 310

La Jolla, CA 92037

(800) 898-2020

Provider ID: 268757

License: A124698

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 145

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Chang, Tom MD

9850 Genesee Ave Ste 310

La Jolla, CA 92037

(800) 898-2020

Provider ID: 270366

License: A69909

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Armenian, Cantonese,

Croatian, Korean, Mandarin,

Spanish, Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Special Expertise: Deafness or

Hard-of-Hearing, Co-occuring

Disorders

Coden, Daniel MD

9850 Genesee Ave Ste 310

La Jolla, CA 92037

(800) 898-2020

Provider ID: 269295

License: G57587

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Gollogly, Heidrun MD

9850 Genesee Ave Ste 310

La Jolla, CA 92037

(800) 898-2020

Provider ID: 269128

License: A134761

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: French,

German, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Mcgraw, Joseph MD

9850 Genesee Ave Ste 310

La Jolla, CA 92037

(800) 898-2020

Provider ID: 269707

License: A155228

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 146

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Accepting New Members: Yes accessibility indicators are not

Morrison-reyes, Joshua MD Hours: M-SA 9AM-5PM present.

9850 Genesee Ave Ste 310 PTA: Yes

La Jolla, CA 92037 Other Language: Spanish,

(858) 457-3010 Tagalog Samuel, Michael MD

Provider ID: 269183 Cultural Competency: NR 9850 Genesee Ave Ste 310

License: A125435 Accessibility: B; Members La Jolla, CA 92037

Credentials and/or board should call the provider’s (800) 898-2020

certification: No office to discuss their Provider ID: 268596

Accepting New Members: Yes accessibility needs when there License: A83237

Hours: M-SA 9AM-5PM is limited access or when Credentials and/or board

PTA: No accessibility indicators are not certification: No

Other Language: Armenian, present. Accepting New Members: Yes

Cantonese, Indonesian, Hours: M-SA 9AM-5PM

Mandarin, Spanish, Tagalog, PTA: No

Vietnamese Pratt, Steven MD Other Language: Armenian,

Cultural Competency: NR 9850 Genesee Ave Ste 310 Cantonese, Mandarin,

Accessibility: B; Members La Jolla, CA 92037 Spanish, Vietnamese

should call the provider’s (800) 898-2020 Cultural Competency: NR

office to discuss their Provider ID: 269324 Accessibility: B; Members

accessibility needs when there License: G32379 should call the provider’s

is limited access or when Credentials and/or board office to discuss their

accessibility indicators are not certification: Yes accessibility needs when there

present. Accepting New Members: Yes is limited access or when

Hours: M-SA 9AM-5PM accessibility indicators are not

PTA: Yes present.

Perry, Arthur MD Other Language: Spanish, Special Expertise: Deafness or

9850 Genesee Ave Ste 310 Tagalog, Vietnamese Hard-of-Hearing, Co-occuring

La Jolla, CA 92037 Cultural Competency: NR Disorders

(858) 457-3010 Accessibility: B; Members

Provider ID: 265703 should call the provider’s 92093 License: C37934 office to discuss their

Credentials and/or board accessibility needs when there Echegoyen, Julio MD

certification: Yes is limited access or when 9415 Campus Point Dr

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 147

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

La Jolla, CA 92093

(858) 534-6290

Provider ID: 257136

License: A121431

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA MESA

91942

Binder, Nicholas MD

5565 Grossmont Center Dr Ste

3 Bldg 2

La Mesa, CA 91942

(619) 697-4600

Provider ID: 268754

License: A124698

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Carraby, Arnett MD

8851 Center Dr Ste 406

La Mesa, CA 91942

(619) 425-7755

Provider ID: 269060

License: G47836

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Tagalog, Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Chavez, Cesar MD

8851 Center Dr Ste 406

La Mesa, CA 91942

(619) 425-7755

Provider ID: 268778

License: G51615

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Delengocky, Tayson DO

8851 Center Dr Ste 406

La Mesa, CA 91942

(619) 425-7755

Provider ID: 268959

License: 20A12784

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 148

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Other Language: Farsi, certification: No

French, Spanish, Tagalog, Accepting New Members: Yes

Vietnamese Gollogly, Heidrun MD Hours: M-SA 9AM-5PM

Cultural Competency: NR 5565 Grossmont Center Dr Ste PTA: No

Accessibility: B; Members 551 Cultural Competency: NR

should call the provider’s La Mesa, CA 91942 Accessibility: B; Members

office to discuss their (800) 898-2020 should call the provider’s

accessibility needs when there Provider ID: 269127 office to discuss their

is limited access or when License: A134761 accessibility needs when there

accessibility indicators are not Credentials and/or board is limited access or when

present. certification: No accessibility indicators are not

Accepting New Members: Yes present.

Hours: M-SA 9AM-5PM

Echegoyen, Julio MD PTA: No

8851 Center Dr Ste 406 Other Language: French, Ho, Joseph MD

La Mesa, CA 91942 German, Spanish 5565 Grossmont Center Dr Ste

(619) 425-7755 Cultural Competency: NR 3 Bldg 2

Provider ID: 268935 Accessibility: B; Members La Mesa, CA 91942

License: A121431 should call the provider’s (800) 898-2020

Credentials and/or board office to discuss their Provider ID: 268884

certification: No accessibility needs when there License: A137389

Accepting New Members: Yes is limited access or when Credentials and/or board

Hours: M-SA 9AM-5PM accessibility indicators are not certification: No

PTA: No present. Accepting New Members: Yes

Other Language: Spanish, Hours: M-SA 9AM-5PM

Tagalog PTA: No

Cultural Competency: NR Haight, Bruce MD Other Language: Chinese,

Accessibility: B; Members 5565 Grossmont Center Dr Ste Mandarin

should call the provider’s 551 Bldg 3 Cultural Competency: NR

office to discuss their La Mesa, CA 91942 Accessibility: B; Members

accessibility needs when there (619) 465-2020 should call the provider’s

is limited access or when Provider ID: 269112 office to discuss their

accessibility indicators are not License: G41117 accessibility needs when there

present. Credentials and/or board is limited access or when

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 149

Page 172: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

accessibility indicators are not

present.

Kownacki, John MD

5565 Grossmont Center Dr Ste

551 Bldg 3

La Mesa, CA 91942

(619) 465-2020

Provider ID: 269085

License: G84672

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Mani, Hamid MD

8851 Center Dr Ste 406

La Mesa, CA 91942

(619) 425-7755

Provider ID: 269230

License: A40472

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Farsi, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Mani, Majid MD

8851 Center Dr Ste 406

La Mesa, CA 91942

(619) 425-7755

Provider ID: 269194

License: A60640

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Mani, Nasrin MD

8851 Center Dr Ste 406

La Mesa, CA 91942

(619) 425-7755

Provider ID: 269200

License: A40473

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Faroese, Farsi, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Mcgraw, Joseph MD

5565 Grossmont Center Dr Ste

551

La Mesa, CA 91942

(619) 465-2020

Provider ID: 269699

License: A155228

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 150

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Credentials and/or board office to discuss their License: A127706

certification: No accessibility needs when there Credentials and/or board

Accepting New Members: Yes is limited access or when certification: No

Hours: M-SA 9AM-5PM accessibility indicators are not Accepting New Members: Yes

PTA: No present. Hours: M-SA 9AM-5PM

Cultural Competency: NR PTA: No

Accessibility: B; Members Other Language: Arabic,

should call the provider’s Moss, Jason MD Farsi, French, Greek, Italian,

office to discuss their 8851 Center Dr Ste 406 Spanish

accessibility needs when there La Mesa, CA 91942 Cultural Competency: NR

is limited access or when (619) 425-7755 Accessibility: B; Members

accessibility indicators are not Provider ID: 268758 should call the provider’s

present. License: A130529 office to discuss their

Credentials and/or board accessibility needs when there

certification: No is limited access or when

Morrison-reyes, Joshua MD Accepting New Members: Yes accessibility indicators are not

5565 Grossmont Center Dr Ste Hours: M-SA 9AM-5PM present.

551 Bldg 3 PTA: No

La Mesa, CA 91942 Other Language: Spanish

(619) 465-2020 Cultural Competency: NR Pons, Mauricio MD

Provider ID: 269182 Accessibility: B; Members 8851 Center Dr Ste 406

License: A125435 should call the provider’s La Mesa, CA 91942

Credentials and/or board office to discuss their (619) 425-7755

certification: No accessibility needs when there Provider ID: 269243

Accepting New Members: Yes is limited access or when License: A87650

Hours: M-SA 9AM-5PM accessibility indicators are not Credentials and/or board

PTA: No present. certification: No

Other Language: Armenian, Accepting New Members: Yes

Cantonese, Indonesian, Hours: M-SA 9AM-5PM

Mandarin, Spanish, Tagalog, Papastergiou, Georgios MD PTA: No

Vietnamese 8851 Center Dr Ste 406 Other Language: Spanish

Cultural Competency: NR La Mesa, CA 91942 Cultural Competency: NR

Accessibility: B; Members (619) 425-7755 Accessibility: B; Members

should call the provider’s Provider ID: 269191 should call the provider’s

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 151

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

office to discuss their (619) 465-2020 should call the provider’s

accessibility needs when there Provider ID: 269038 office to discuss their

is limited access or when License: C31021 accessibility needs when there

accessibility indicators are not Credentials and/or board is limited access or when

present. certification: Yes accessibility indicators are not

Accepting New Members: Yes present.

Hours: M-SA 9AM-5PM

Peairs, James MD PTA: Yes

8851 Center Dr Ste 406 Other Language: Spanish Scher, Barry MD

La Mesa, CA 91942 Cultural Competency: NR 8851 Center Dr Ste 406

(619) 425-7755 Accessibility: B, W; Members La Mesa, CA 91942

Provider ID: 268820 should call the provider’s (619) 425-7755

License: A155296 office to discuss their Provider ID: 268829

Credentials and/or board accessibility needs when there License: G23827

certification: No is limited access or when Credentials and/or board

Accepting New Members: Yes accessibility indicators are not certification: No

Hours: M-SA 9AM-5PM present. Accepting New Members: Yes

PTA: No Hours: M-SA 9AM-5PM

Other Language: Arabic, PTA: No

Spanish Sassani, Patrick MD Other Language: Spanish

Cultural Competency: NR 8851 Center Dr Ste 406 Cultural Competency: NR

Accessibility: B; Members La Mesa, CA 91942 Accessibility: B; Members

should call the provider’s (619) 425-7755 should call the provider’s

office to discuss their Provider ID: 269077 office to discuss their

accessibility needs when there License: A150205 accessibility needs when there

is limited access or when Credentials and/or board is limited access or when

accessibility indicators are not certification: No accessibility indicators are not

present. Accepting New Members: Yes present.

Hours: M-SA 9AM-5PM

PTA: No

Rice, Lawrence MD Other Language: Arabic, Skaf, Ayham MD

5565 Grossmont Center Dr Ste Spanish, Tagalog 8851 Center Dr Ste 406

551 Cultural Competency: NR La Mesa, CA 91942

La Mesa, CA 91942 Accessibility: B; Members (619) 425-7755

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 152

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Provider ID: 269075

License: A120584

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Wasserstrom, Jeffrey MD

5565 Grossmont Center Dr Ste

551 Bldg 3

La Mesa, CA 91942

(619) 698-1088

Provider ID: 66034

License: G54813

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Zabaneh, Alexander MD

5565 Grossmont Center Dr Ste

551

La Mesa, CA 91942

(800) 898-2020

Provider ID: 269123

License: A154697

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

NATIONAL CITY

91950

Abdallah, Walid MD

1520 E Plaza Blvd

National City, CA 91950

(619) 425-7755

Provider ID: 266063

License: A146829

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Korean, Mandarin, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Carraby, Arnett MD

1520 E Plaza Blvd

National City, CA 91950

(619) 425-7755

Provider ID: 268383

License: G47836

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 153

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Other Language: Spanish,

Tagalog, Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Chang, Tom MD

2240 E Plaza Blvd Ste F G

National City, CA 91950

(800) 898-2020

Provider ID: 270365

License: A69909

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Armenian, Cantonese,

Croatian, Korean, Mandarin,

Spanish, Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Special Expertise: Deafness or

Hard-of-Hearing, Co-occuring

Disorders

Echegoyen, Julio MD

1520 E Plaza Blvd

National City, CA 91950

(619) 425-7755

Provider ID: 268352

License: A121431

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Gollogly, Heidrun MD

655 Euclid Ave Ste 302

National City, CA 91950

(619) 472-1010

Provider ID: 269126

License: A134761

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: French,

German, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Haight, Bruce MD

655 Euclid Ave Ste 302

National City, CA 91950

(619) 472-1010

Provider ID: 269113

License: G41117

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 154

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is limited access or when

accessibility indicators are not

present.

Kownacki, John MD

655 Euclid Ave Ste 302

National City, CA 91950

(619) 472-1010

Provider ID: 269086

License: G84672

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Khandan, Sara MD

1520 E Plaza Blvd

National City, CA 91950

(619) 425-7755

Provider ID: 268351

License: A155828

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Mani, Majid MD

1520 E Plaza Blvd

National City, CA 91950

(619) 425-7755

Provider ID: 268295

License: A60640

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Mani, Nasrin MD

1520 E Plaza Blvd

National City, CA 91950

(619) 425-7755

Provider ID: 269201

License: A40473

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Faroese, Farsi, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Mcgraw, Joseph MD

2240 E Plaza Blvd Ste F

National City, CA 91950

(619) 470-2700

Provider ID: 269700

License: A155228

Credentials and/or board

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 155

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certification: No PTA: No

Accepting New Members: Yes Miller, Douglas MD Other Language: Spanish,

Hours: M-SA 9AM-5PM 2240 E Plaza Blvd Ste G Tagalog, Vietnamese

PTA: No National City, CA 91950 Cultural Competency: NR

Cultural Competency: NR (619) 470-2700 Accessibility: B; Members

Accessibility: B; Members Provider ID: 268954 should call the provider’s

should call the provider’s License: G52627 office to discuss their

office to discuss their Credentials and/or board accessibility needs when there

accessibility needs when there certification: No is limited access or when

is limited access or when Accepting New Members: Yes accessibility indicators are not

accessibility indicators are not Hours: M-SA 9AM-5PM present.

present. PTA: No

Other Language: Spanish,

Tagalog, Vietnamese Morrison-reyes, Joshua MD

Mcgraw, Joseph MD Cultural Competency: NR 655 Euclid Ave Ste 302

2240 E Plaza Blvd Ste G Accessibility: B; Members National City, CA 91950

National City, CA 91950 should call the provider’s (619) 472-1010

(619) 470-2700 office to discuss their Provider ID: 269180

Provider ID: 269701 accessibility needs when there License: A125435

License: A155228 is limited access or when Credentials and/or board

Credentials and/or board accessibility indicators are not certification: No

certification: No present. Accepting New Members: Yes

Accepting New Members: Yes Hours: M-SA 9AM-5PM

Hours: M-SA 9AM-5PM PTA: No

PTA: No Miller, Douglas MD Other Language: Armenian,

Cultural Competency: NR 2240 E Plaza Blvd Ste F Cantonese, Indonesian,

Accessibility: B; Members National City, CA 91950 Mandarin, Spanish, Tagalog,

should call the provider’s (619) 470-2700 Vietnamese

office to discuss their Provider ID: 268955 Cultural Competency: NR

accessibility needs when there License: G52627 Accessibility: B; Members

is limited access or when Credentials and/or board should call the provider’s

accessibility indicators are not certification: No office to discuss their

present. Accepting New Members: Yes accessibility needs when there

Hours: M-SA 9AM-5PM is limited access or when

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 156

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

accessibility indicators are not License: A130529 office to discuss their

present.

Morrison-reyes, Joshua MD

2240 E Plaza Blvd Ste F And G

National City, CA 91950

(619) 470-2700

Provider ID: 269181

License: A125435

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Armenian,

Cantonese, Indonesian,

Mandarin, Spanish, Tagalog,

Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Moss, Jason MD

1520 E Plaza Blvd

National City, CA 91950

(619) 425-7755

Provider ID: 268290

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Papastergiou, Georgios MD

1520 E Plaza Blvd

National City, CA 91950

(619) 425-7755

Provider ID: 268327

License: A127706

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Farsi, French, Greek, Italian,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Patel, Gitane MD

2240 E Plaza Blvd Ste F And G

National City, CA 91950

(619) 470-2700

Provider ID: 268742

License: A108603

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Gujarati, Spanish, Tagalog,

Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Patel, Sarjan MD

2240 E Plaza Blvd Ste F And G

National City, CA 91950

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 157

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

(800) 898-2020 Accessibility: B; Members National City, CA 91950

Provider ID: 268800 should call the provider’s (619) 425-7755

License: A114976 office to discuss their Provider ID: 268366

Credentials and/or board accessibility needs when there License: A155296

certification: No is limited access or when Credentials and/or board

Accepting New Members: Yes accessibility indicators are not certification: No

Hours: M-SA 9AM-5PM present. Accepting New Members: Yes

PTA: No Hours: M-SA 9AM-5PM

Other Language: Gujarati, PTA: No

Hindi, Spanish, Tagalog, Prabhu, Sujata MD Other Language: Arabic,

Vietnamese 2240 E Plaza Blvd Ste F And G Spanish

Cultural Competency: NR National City, CA 91950 Cultural Competency: NR

Accessibility: B; Members (619) 470-2700 Accessibility: B; Members

should call the provider’s Provider ID: 268921 should call the provider’s

office to discuss their License: A115965 office to discuss their

accessibility needs when there Credentials and/or board accessibility needs when there

is limited access or when certification: No is limited access or when

accessibility indicators are not Accepting New Members: Yes accessibility indicators are not

present. Hours: M-SA 9AM-5PM present.

PTA: No

Other Language: Spanish,

Pons, Mauricio MD Tagalog, Telugu, Vietnamese Rajsbaum, Martin MD

1520 E Plaza Blvd Cultural Competency: NR 1520 E Plaza Blvd

National City, CA 91950 Accessibility: B; Members National City, CA 91950

(619) 425-7755 should call the provider’s (619) 425-7755

Provider ID: 268353 office to discuss their Provider ID: 268294

License: A87650 accessibility needs when there License: A42670

Credentials and/or board is limited access or when Credentials and/or board

certification: No accessibility indicators are not certification: No

Accepting New Members: Yes present. Accepting New Members: Yes

Hours: M-SA 9AM-5PM Hours: M-SA 9AM-5PM

PTA: No PTA: No

Other Language: Spanish Peairs, James MD Other Language: Arabic,

Cultural Competency: NR 1520 E Plaza Blvd Russian, Spanish, Tagalog

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 158

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Cultural Competency: NR National City, CA 91950 Cultural Competency: NR

Accessibility: B; Members (619) 425-7755 Accessibility: B; Members

should call the provider’s Provider ID: 268285 should call the provider’s

office to discuss their License: A150205 office to discuss their

accessibility needs when there Credentials and/or board accessibility needs when there

is limited access or when certification: No is limited access or when

accessibility indicators are not Accepting New Members: Yes accessibility indicators are not

present. Hours: M-SA 9AM-5PM present.

PTA: No

Other Language: Arabic,

Rice, Lawrence MD Spanish, Tagalog Treger, Paul MD

655 Euclid Ave Ste 302 Cultural Competency: NR 655 Euclid Ave Ste 302

National City, CA 91950 Accessibility: B; Members National City, CA 91950

(619) 472-1010 should call the provider’s (619) 472-1010

Provider ID: 269039 office to discuss their Provider ID: 268812

License: C31021 accessibility needs when there License: G26803

Credentials and/or board is limited access or when Credentials and/or board

certification: No accessibility indicators are not certification: No

Accepting New Members: Yes present. Accepting New Members: Yes

Hours: M-SA 9AM-5PM Hours: M-SA 9AM-5PM

PTA: No PTA: No

Other Language: Spanish Skaf, Ayham MD Cultural Competency: NR

Cultural Competency: NR 1520 E Plaza Blvd Accessibility: B; Members

Accessibility: B; Members National City, CA 91950 should call the provider’s

should call the provider’s (619) 425-7755 office to discuss their

office to discuss their Provider ID: 268279 accessibility needs when there

accessibility needs when there License: A120584 is limited access or when

is limited access or when Credentials and/or board accessibility indicators are not

accessibility indicators are not certification: No present.

present. Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No Wainess, Reid MD

Sassani, Patrick MD Other Language: Arabic, 2240 E Plaza Blvd Ste F & G

1520 E Plaza Blvd Spanish National City, CA 91950

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 159

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

(800) 898-2020 Cultural Competency: NR Lozier, Jeffrey MD

Provider ID: 254760

License: A108766

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Armenian,

Cantonese, Hebrew,

Mandarin, Spanish,

Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Wasserstrom, Jeffrey MD

655 Euclid Ave Ste 302

National City, CA 91950

(619) 472-1010

Provider ID: 129187

License: G54813

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Zabaneh, Alexander MD

655 Euclid Ave Ste 302

National City, CA 91950

(619) 472-1010

Provider ID: 269121

License: A154697

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

POWAY

92064

15611 Pomerado Rd Ste 400

Poway, CA 92064

(858) 675-3140

Provider ID: 270187

License: G54719

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92103

El Khatib, Nora MD

233 Lewis St

San Diego, CA 92103

(619) 501-9050

Provider ID: 269853

License: A140794

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 160

Page 183: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Other Language: Arabic, Haak, Logan MD PTA: Yes

Spanish 4077 5th Ave Other Language: Spanish,

Cultural Competency: NR San Diego, CA 92103 Tagalog, Vietnamese

Accessibility: B; Members (619) 294-8111 Cultural Competency: NR

should call the provider’s Provider ID: 270058 Accessibility: B, W; Members

office to discuss their License: A110896 should call the provider’s

accessibility needs when there Credentials and/or board office to discuss their

is limited access or when certification: No accessibility needs when there

accessibility indicators are not Accepting New Members: Yes is limited access or when

present. Hours: M-SA 9AM-5PM accessibility indicators are not

PTA: No present.

Other Language: Farsi,

Gualtieri, Christopher MD Spanish 92111 3969 4th Ave Ste 300 Cultural Competency: NR

San Diego, CA 92103 Accessibility: B; Members Binder, Nicholas MD

(619) 688-2648 should call the provider’s 4344 Convoy St Ste C2

Provider ID: 252313 office to discuss their San Diego, CA 92111

License: G73020 accessibility needs when there (858) 565-8822

Credentials and/or board is limited access or when Provider ID: 268755

certification: Yes accessibility indicators are not License: A124698

Accepting New Members: Yes present. Credentials and/or board

Hours: M-SA 9AM-5PM certification: No

PTA: Yes 92105 Accepting New Members: Yes

Other Language: Spanish Hours: M-SA 9AM-5PM

Cultural Competency: NR Huynh, Paul MD PTA: No

Accessibility: B, W; Members 4844 University Ave Ste A Cultural Competency: NR

should call the provider’s San Diego, CA 92105 Accessibility: B; Members

office to discuss their (619) 283-1303 should call the provider’s

accessibility needs when there Provider ID: 245200 office to discuss their

is limited access or when License: A79141 accessibility needs when there

accessibility indicators are not Credentials and/or board is limited access or when

present. certification: No accessibility indicators are not

Accepting New Members: Yes present.

Hours: M-SA 9AM-5PM

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 161

Page 184: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Chang, Tom MD

4344 Convoy St Ste C2

San Diego, CA 92111

(858) 565-8822

Provider ID: 270361

License: A69909

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Armenian, Cantonese,

Croatian, Korean, Mandarin,

Spanish, Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Special Expertise: Deafness or

Hard-of-Hearing, Co-occuring

Disorders

Mcgraw, Joseph MD

4344 Convoy St Ste C2

San Diego, CA 92111

(800) 898-2020

Provider ID: 269704

License: A155228

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Miller, Douglas MD

4344 Convoy St Ste C2

San Diego, CA 92111

(858) 565-8822

Provider ID: 99220

License: G52627

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Tagalog, Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Patel, Gitane MD

4344 Convoy St Ste C2

San Diego, CA 92111

(800) 898-2020

Provider ID: 268743

License: A108603

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Gujarati, Spanish, Tagalog,

Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Patel, Sarjan MD

4344 Convoy St Ste C2

San Diego, CA 92111

(800) 898-2020

Provider ID: 268801

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 162

Page 185: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

License: A114976

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Gujarati,

Hindi, Spanish, Tagalog,

Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Prabhu, Sujata MD

4344 Convoy St Ste C2

San Diego, CA 92111

(800) 898-2020

Provider ID: 268919

License: A115965

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Tagalog, Telugu, Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Wainess, Reid MD

4344 Convoy St Ste C2

San Diego, CA 92111

(800) 898-2020

Provider ID: 254762

License: A108766

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Armenian,

Cantonese, Hebrew,

Mandarin, Spanish,

Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92115

Binder, Nicholas MD

6945 El Cajon Blvd

San Diego, CA 92115

(619) 697-4600

Provider ID: 268751

License: A124698

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Katzman, Barry MD

6945 El Cajon Blvd

San Diego, CA 92115

(800) 898-2020

Provider ID: 247366

License: A34834

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish,

Tagalog, Vietnamese

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 163

Page 186: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Cultural Competency: NR (619) 697-4600 Other Language: Armenian,

Accessibility: B; Members Provider ID: 99211 Cantonese, Indonesian,

should call the provider’s License: G52627 Mandarin, Spanish, Tagalog,

office to discuss their Credentials and/or board Vietnamese

accessibility needs when there certification: No Cultural Competency: NR

is limited access or when Accepting New Members: Yes Accessibility: B; Members

accessibility indicators are not Hours: M-SA 9AM-5PM should call the provider’s

present. PTA: No office to discuss their

Other Language: Spanish, accessibility needs when there

Tagalog, Vietnamese is limited access or when

Mcgraw, Joseph MD Cultural Competency: NR accessibility indicators are not

6945 El Cajon Blvd Accessibility: B; Members present.

San Diego, CA 92115 should call the provider’s

(619) 697-4600 office to discuss their

Provider ID: 269702 accessibility needs when there Patel, Gitane MD

License: A155228 is limited access or when 6945 El Cajon Blvd

Credentials and/or board accessibility indicators are not San Diego, CA 92115

certification: No present. (619) 697-4600

Accepting New Members: Yes Provider ID: 268738

Hours: M-SA 9AM-5PM License: A108603

PTA: No Morrison-reyes, Joshua MD Credentials and/or board

Cultural Competency: NR 6945 El Cajon Blvd certification: No

Accessibility: B; Members San Diego, CA 92115 Accepting New Members: Yes

should call the provider’s (619) 697-4600 Hours: M-SA 9AM-5PM

office to discuss their Provider ID: 269178 PTA: Yes

accessibility needs when there License: A125435 Other Language: Arabic,

is limited access or when Credentials and/or board Gujarati, Spanish, Tagalog,

accessibility indicators are not certification: No Vietnamese

present. Accepting New Members: Yes Cultural Competency: NR

Hours: M-SA 9AM-5PM Accessibility: B; Members

PTA: No should call the provider’s

Miller, Douglas MD office to discuss their

6945 El Cajon Blvd accessibility needs when there

San Diego, CA 92115 is limited access or when

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 164

Page 187: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

accessibility indicators are not Credentials and/or board is limited access or when

present. certification: Yes accessibility indicators are not

Accepting New Members: Yes present.

Hours: M-SA 9AM-5PM

Patel, Sarjan MD PTA: No 92126 6945 El Cajon Blvd Other Language: Spanish,

San Diego, CA 92115 Tagalog, Telugu, Vietnamese Huynh, Paul MD

(619) 697-4600 Cultural Competency: NR 10737 Camino Ruiz Ste 100

Provider ID: 268798 Accessibility: B; Members San Diego, CA 92126

License: A114976 should call the provider’s (858) 549-3200

Credentials and/or board office to discuss their Provider ID: 245199

certification: Yes accessibility needs when there License: A79141

Accepting New Members: Yes is limited access or when Credentials and/or board

Hours: M-SA 9AM-5PM accessibility indicators are not certification: Yes

PTA: Yes present. Accepting New Members: Yes

Other Language: Gujarati, Hours: M-SA 9AM-5PM

Hindi, Spanish, Tagalog, PTA: Yes

Vietnamese Zabaneh, Alexander MD Other Language: Spanish,

Cultural Competency: NR 6945 El Cajon Blvd Tagalog, Vietnamese

Accessibility: B, W; Members San Diego, CA 92115 Cultural Competency: NR

should call the provider’s (619) 697-4600 Accessibility: B, W; Members

office to discuss their Provider ID: 269122 should call the provider’s

accessibility needs when there License: A154697 office to discuss their

is limited access or when Credentials and/or board accessibility needs when there

accessibility indicators are not certification: No is limited access or when

present. Accepting New Members: Yes accessibility indicators are not

Hours: M-SA 9AM-5PM present.

PTA: No

Prabhu, Sujata MD Other Language: Arabic

6945 El Cajon Blvd Cultural Competency: NR Ng, Diana MD

San Diego, CA 92115 Accessibility: B; Members 10737 Camino Ruiz Ste 100

(800) 898-2020 should call the provider’s San Diego, CA 92126

Provider ID: 268916 office to discuss their (858) 549-3200

License: A115965 accessibility needs when there Provider ID: 270011

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 165

Page 188: 2021 Direktoryo ng Provider at Parmasya Blue Shield

126

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

License: A115695

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Chinese,

Yue Chinese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN MARCOS

92069

Prestera, Tory MD

100 N Rancho Santa Fe Rd Ste

San Marcos, CA 92069

(760) 598-0400

Provider ID: 204707

License: A62321

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish,

Thai

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Optometrist

ALPINE

91901

Aoto, Kim OD

1620 Alpine Blvd Ste 117

Alpine, CA 91901

(800) 898-2020

Provider ID: 268720

License: OPT14524

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Dyer, Sharon OD

1620 Alpine Blvd Ste 117

Alpine, CA 91901

(619) 445-2687

Provider ID: 268868

License: OPT33450

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Soriano, Catherine OD

1620 Alpine Blvd Ste 117

Alpine, CA 91901

(800) 898-2020

Provider ID: 268727

License: OPT13109

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 166

Page 189: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

PTA: No

Other Language: Spanish,

Tagalog, Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

CHULA VISTA

91910

Bakriwala, Ketan OD

342 F St

Chula Vista, CA 91910

(619) 422-1471

Provider ID: 268773

License: OPT14277

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Gujarati,

Spanish, Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Biaggi, Michelle OD

342 F St

Chula Vista, CA 91910

(619) 422-1471

Provider ID: 265528

License: OPT33462

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Mascareno, Efrain OD

440 4th Ave # 9

Chula Vista, CA 91910

(619) 427-2020

Provider ID: 268680

License: OPT10906

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Nguyen, Thu OD

342 F St

Chula Vista, CA 91910

(619) 422-1471

Provider ID: 265518

License: OPT14274

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Tagalog, Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 167

Page 190: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

91911

El-moghrabi, Roula OD

835 3rd Ave Ste A

Chula Vista, CA 91911

(619) 425-7755

Provider ID: 245689

License: OPT34126

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

French, Spanish, Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

El-moghrabi, Nancy OD

835 3rd Ave Ste A

Chula Vista, CA 91911

(619) 425-7755

Provider ID: 258049

License: OPT34125

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

91915

Mascareno, Efrain OD

2260 Otay Lakes Rd Ste 111

Chula Vista, CA 91915

(619) 421-5550

Provider ID: 268679

License: OPT10906

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

EL CAJON

92020

Aoto, Kim OD

450 Fletcher Pkwy Ste 112

El Cajon, CA 92020

(800) 898-2020

Provider ID: 268721

License: OPT14524

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Dyer, Sharon OD

450 Fletcher Pkwy Ste 112

El Cajon, CA 92020

(619) 440-5400

Provider ID: 268869

License: OPT33450

Credentials and/or board

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 168

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Soriano, Catherine OD

450 Fletcher Pkwy Ste 112

El Cajon, CA 92020

(800) 898-2020

Provider ID: 268729

License: OPT13109

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Tagalog, Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ESCONDIDO

92025

Aoto, Kim OD

830 W Valley Pkwy Ste 300

Escondido, CA 92025

(619) 463-0331

Provider ID: 268719

License: OPT14524

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Dyer, Sharon OD

830 W Valley Pkwy Ste 300

Escondido, CA 92025

(760) 743-5872

Provider ID: 268870

License: OPT33450

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Soriano, Catherine OD

830 W Valley Pkwy Ste 300

Escondido, CA 92025

(800) 898-2020

Provider ID: 268730

License: OPT13109

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Tagalog, Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 169

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

accessibility indicators are not

present.

LA JOLLA

92037

Moshtaghi, Mehri OD

9850 Genesee Ave Ste 310

La Jolla, CA 92037

(800) 898-2020

Provider ID: 279262

License: OPT13972

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92093

Hoo, Pamela OD

9415 Campus Point Dr

La Jolla, CA 92093

(858) 534-6290

Provider ID: 269621

License: OPT11033

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Mcclean, Esmeralda OD

9415 Campus Point Dr

La Jolla, CA 92093

(858) 534-6290

Provider ID: 269907

License: OPT15001

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA MESA

91942

Dyer, Sharon OD

5565 Grossmont Center Dr Ste

551

La Mesa, CA 91942

(800) 898-2020

Provider ID: 268873

License: OPT33450

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

El-moghrabi, Roula OD

8851 Center Dr Ste 406

La Mesa, CA 91942

(619) 425-7755

Provider ID: 245697

License: OPT34126

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 170

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3

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

French, Spanish, Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Soriano, Catherine OD

5565 Grossmont Center Dr Ste

La Mesa, CA 91942

(800) 898-2020

Provider ID: 268732

License: OPT13109

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Tagalog, Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

NATIONAL CITY

91950

Aoto, Kim OD

2240 E Plaza Blvd Ste F-g

National City, CA 91950

(800) 898-2020

Provider ID: 268722

License: OPT14524

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Dyer, Sharon OD

2240 E Plaza Blvd Ste F And G

National City, CA 91950

(800) 898-2020

Provider ID: 268872

License: OPT33450

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

El-moghrabi, Roula OD

2835 Highland Ave Ste B

National City, CA 91950

(844) 200-2426

Provider ID: 245696

License: OPT34126

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

French, Spanish, Tagalog

Cultural Competency: NR

Accessibility: B; Members

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 171

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

El-moghrabi, Roula OD

1520 E Plaza Blvd

National City, CA 91950

(619) 425-7755

Provider ID: 268284

License: OPT34126

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

French, Spanish, Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

El-moghrabi, Nancy OD

1520 E Plaza Blvd

National City, CA 91950

(619) 425-7755

Provider ID: 268380

License: OPT34125

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Soriano, Catherine OD

2240 E Plaza Blvd Ste F And G

National City, CA 91950

(800) 898-2020

Provider ID: 268728

License: OPT13109

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Tagalog, Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Soriano, Catherine OD

655 Euclid Ave Ste 302

National City, CA 91950

(800) 898-2020

Provider ID: 268731

License: OPT13109

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Tagalog, Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

OCEANSIDE

92056

Ring, Robert OD

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 172

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

3998 Vista Way Ste 204

Oceanside, CA 92056

(760) 726-9383

Provider ID: 269380

License: OPT6781

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

POWAY

92064

Kim, Michelle OD

15611 Pomerado Rd Ste 400

Poway, CA 92064

(858) 675-3141

Provider ID: 270014

License: OPT11566

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92111

Aoto, Kim OD

4344 Convoy St Ste C2

San Diego, CA 92111

(619) 463-0331

Provider ID: 268718

License: OPT14524

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Dyer, Sharon OD

4344 Convoy St Ste C2

San Diego, CA 92111

(800) 898-3788

Provider ID: 268871

License: OPT33450

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92115

Aoto, Kim OD

6945 El Cajon Blvd

San Diego, CA 92115

(800) 898-2020

Provider ID: 268723

License: OPT14524

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 173

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

PTA: No Soriano, Catherine OD PTA: No

Other Language: Spanish, 6945 El Cajon Blvd Other Language: Arabic,

Vietnamese San Diego, CA 92115 French, Spanish, Tagalog

Cultural Competency: NR (619) 697-4600 Cultural Competency: NR

Accessibility: B; Members Provider ID: 268726 Accessibility: B; Members

should call the provider’s License: OPT13109 should call the provider’s

office to discuss their Credentials and/or board office to discuss their

accessibility needs when there certification: No accessibility needs when there

is limited access or when Accepting New Members: Yes is limited access or when

accessibility indicators are not Hours: M-SA 9AM-5PM accessibility indicators are not

present. PTA: Yes present.

Other Language: Spanish,

Tagalog, Vietnamese 92129 Dyer, Sharon OD Cultural Competency: NR

6945 El Cajon Blvd Accessibility: B; Members El-moghrabi, Roula OD

San Diego, CA 92115 should call the provider’s 9995 Carmel Mountain Rd Ste

(619) 697-4600 office to discuss their B10-11

Provider ID: 268867 accessibility needs when there San Diego, CA 92129

License: OPT33450 is limited access or when (844) 200-2426

Credentials and/or board accessibility indicators are not Provider ID: 245692

certification: No present. License: OPT34126

Accepting New Members: Yes Credentials and/or board

Hours: M-SA 9AM-5PM 92126 certification: No

PTA: No Accepting New Members: Yes

Cultural Competency: NR El-moghrabi, Roula OD Hours: M-SA 9AM-5PM

Accessibility: B; Members 10737 Camino Ruiz Ste 138 PTA: No

should call the provider’s San Diego, CA 92126 Other Language: Arabic,

office to discuss their (844) 200-2426 French, Spanish, Tagalog

accessibility needs when there Provider ID: 245695 Cultural Competency: NR

is limited access or when License: OPT34126 Accessibility: B; Members

accessibility indicators are not Credentials and/or board should call the provider’s

present. certification: No office to discuss their

Accepting New Members: Yes accessibility needs when there

Hours: M-SA 9AM-5PM is limited access or when

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 174

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

accessibility indicators are not

present.

92131

El-moghrabi, Roula OD

9855 Erma Rd Ste 105

San Diego, CA 92131

(844) 200-2426

Provider ID: 245694

License: OPT34126

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

French, Spanish, Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

VISTA

92083

Gee, Jennifer OD

134 Grapevine Rd

Vista, CA 92083

(760) 631-5000

Provider ID: 273114

License: OPT14671

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Kim, Michael OD

134 Grapevine Rd

Vista, CA 92083

(760) 631-5000

Provider ID: 245239

License: OPT12174

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Tran, Thuy-diem OD

134 Grapevine Rd

Vista, CA 92083

(760) 631-5000

Provider ID: 245677

License: OPT14292

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92084

Gee, Jennifer OD

1000 Vale Terrace Dr

Vista, CA 92084

(760) 631-5000

Provider ID: 273113

License: OPT14671

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 175

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Mora, Wendy OD

1000 Vale Terrace Dr

Vista, CA 92084

(760) 631-5000

Provider ID: 242634

License: OPT15016

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Rich, Ryan OD

1000 Vale Terrace Dr

Vista, CA 92084

(760) 631-5000

Provider ID: 242998

License: OPT15053

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Tam, Emily OD

1000 Vale Terrace Dr

Vista, CA 92084

(760) 631-5000

Provider ID: 277978

License: OPT15147

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Tran, Thuy-diem OD

1000 Vale Terrace Dr

Vista, CA 92084

(760) 631-5000

Provider ID: 245676

License: OPT14292

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 176

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Otolaryngology

CARLSBAD

92008

Donaldson, Chadwick MD

2390 Faraday Ave

Carlsbad, CA 92008

(858) 909-0770

Provider ID: 268146

License: A84567

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Riedler, Kiersten MD

2390 Faraday Ave

Carlsbad, CA 92008

(858) 909-0770

Provider ID: 256202

License: A135480

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

CHULA VISTA

91910

Jansen, Cornelius MD

577 Third Ave

Chula Vista, CA 91910

(619) 426-5181

Provider ID: 255731

License: G85048

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: French,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

91911

Patsias, Alexis MD

765 Medical Center Ct Ste 210

Chula Vista, CA 91911

(619) 482-0565

Provider ID: 268806

License: A160436

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ESCONDIDO

92029

Fitzgerald, Patrick MD

1955 Citracado Pkwy Ste 200

Escondido, CA 92029

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 177

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

(858) 485-7870

Provider ID: 269266

License: G80210

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA JOLLA

92037

Chang, Angela MD

9834 Genesee Ave Ste 111

La Jolla, CA 92037

(858) 909-0770

Provider ID: 269308

License: A100380

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Chinese,

Mandarin, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Calzada, Audrey MD

9834 Genesee Ave Ste 111

La Jolla, CA 92037

(858) 909-0770

Provider ID: 269278

License: A107965

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA MESA

91942

Busino, Rowley MD

5565 Grossmont Center Dr Ste

101

La Mesa, CA 91942

(619) 464-3353

Provider ID: 53306

License: A112508

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Arabic,

French, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Driskill, Brent MD

5565 Grossmont Center Dr Ste

101

La Mesa, CA 91942

(619) 464-3353

Provider ID: 121484

License: C146197

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 178

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

PTA: No Accepting New Members: Yes

Cultural Competency: NR Moles, Jeremiah MD Hours: M-SA 9AM-5PM

Accessibility: B; Members 5565 Grossmont Center Dr Ste PTA: No

should call the provider’s 101 Bldg 3 Other Language: Spanish

office to discuss their La Mesa, CA 91942 Cultural Competency: NR

accessibility needs when there (619) 464-3353 Accessibility: B; Members

is limited access or when Provider ID: 46814 should call the provider’s

accessibility indicators are not License: A112009 office to discuss their

present. Credentials and/or board accessibility needs when there

certification: Yes is limited access or when

Accepting New Members: Yes accessibility indicators are not

Mccallion, Patrick MD Hours: M-SA 9AM-5PM present.

5565 Grossmont Center Dr Ste PTA: No

101 Bldg 3 Other Language: Arabic,

La Mesa, CA 91942 Farsi, Spanish, Tongan Paul, Supriti MD

(619) 464-3353 Cultural Competency: NR 5565 Grossmont Center Dr Ste

Provider ID: 26600 Accessibility: B; Members 101 Bldg 3

License: G64989 should call the provider’s La Mesa, CA 91942

Credentials and/or board office to discuss their (619) 464-3353

certification: Yes accessibility needs when there Provider ID: 91838

Accepting New Members: Yes is limited access or when License: A120434

Hours: M-SA 9AM-5PM accessibility indicators are not Credentials and/or board

PTA: No present. certification: No

Other Language: Arabic, Accepting New Members: Yes

Spanish Hours: M-SA 9AM-5PM

Cultural Competency: NR Patsias, Alexis MD PTA: No

Accessibility: B; Members 5565 Grossmont Center Dr Ste Other Language: Arabic,

should call the provider’s 101 Hebrew, Spanish

office to discuss their La Mesa, CA 91942 Cultural Competency: NR

accessibility needs when there (619) 464-3353 Accessibility: B; Members

is limited access or when Provider ID: 243551 should call the provider’s

accessibility indicators are not License: A160436 office to discuss their

present. Credentials and/or board accessibility needs when there

certification: No is limited access or when

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 179

Page 202: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

accessibility indicators are not

present.

Pitzer, Geoffrey MD

5565 Grossmont Center Dr Ste

101 Bldg 3

La Mesa, CA 91942

(619) 464-3353

Provider ID: 103378

License: A125888

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Farsi, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Rensink, Michael MD

5565 Grossmont Center Dr Ste

101 Bldg 3

La Mesa, CA 91942

(619) 464-3353

Provider ID: 269082

License: G20200

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Schalch Lepe, Paul MD

5565 Grossmont Center Dr

La Mesa, CA 91942

(619) 464-3353

Provider ID: 122525

License: A92839

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

German, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Schalch Lepe, Paul MD

5565 Grossmont Center Dr Ste

101

La Mesa, CA 91942

(619) 464-3353

Provider ID: 269980

License: A92839

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

German, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Skelton, Sean DO

5565 Grossmont Center Dr Ste

101 Bldg 3

La Mesa, CA 91942

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 180

Page 203: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

(619) 464-3353

Provider ID: 269028

License: 20A7852

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Japanese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

POWAY

92064

Fitzgerald, Patrick MD

15525 Pomerado Rd Ste C1

Poway, CA 92064

(858) 485-7870

Provider ID: 70742

License: G80210

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Learn, Alison MD

15525 Pomerado Rd Ste C1

Poway, CA 92064

(858) 485-7870

Provider ID: 70715

License: G78450

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92121

Riedler, Kiersten MD

5405 Oberlin Dr

San Diego, CA 92121

(858) 909-0770

Provider ID: 256203

License: A135480

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Pediatrics

CHULA VISTA

91911

Tiznado, Ernesto Garcia MD

1635 3rd Ave Ste L

Chula Vista, CA 91911

(619) 425-8901

Provider ID: 269717

License: A45183

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 181

Page 204: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Other Language: Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA JOLLA

92037

Longhurst, Christopher MD

9300 Campus Point Dr

La Jolla, CA 92037

(858) 657-7000

Provider ID: 269432

License: A80051

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA MESA

91942

Adigopula, Bina MD

6942 University Ave Ste A

La Mesa, CA 91942

(619) 698-2184

Provider ID: 218149

License: A45273

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Hindi,

Spanish, Telugu

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

NATIONAL CITY

91950

Bailony, Mohammed MD

655 Euclid Ave Ste 205

National City, CA 91950

(619) 470-1945

Provider ID: 274980

License: A34406

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92126

Karmakar, Kanka MD

10737 Camino Ruiz Ste 235

San Diego, CA 92126

(844) 200-2426

Provider ID: 213847

License: C54941

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Bengali,

Hindi, Polish, Spanish,

Tagalog

Cultural Competency: NR

Accessibility: B; Members

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 182

Page 205: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Physical Medicine /

Rehabilitation

ALPINE

91901

Lao, Jesus MD

1392 Tavern Rd

Alpine, CA 91901

(619) 722-4270

Provider ID: 268762

License: A72729

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Chinese,

Mandarin, Spanish, Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

CARLSBAD

92011

Jaffer, Jihad MD

6010 Hidden Valley Rd Ste 200

Carlsbad, CA 92011

(760) 631-3000

Provider ID: 119557

License: A98822

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Madhav, Sandip MD

6010 Hidden Valley Rd Ste 200

Carlsbad, CA 92011

(760) 631-3000

Provider ID: 256381

License: A128918

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Gujarati

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

CHULA VISTA

91910

Bullock, Andrew DO

344 F St Ste 100

Chula Vista, CA 91910

(619) 379-6579

Provider ID: 268443

License: 20A6842

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Fataleka, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 183

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

is limited access or when

accessibility indicators are not

present.

LA JOLLA

92037

Kasendorf, Roger DO

9834 Genesee Ave Ste 221

La Jolla, CA 92037

(858) 558-1275

Provider ID: 209021

License: 20A12928

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

POWAY

92064

Bullock, Andrew DO

15644 Pomerado Rd Ste 204

Poway, CA 92064

(619) 379-6579

Provider ID: 268442

License: 20A6842

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Farsi,

Fataleka, Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92108

Thompson, Sharron MD

3703 Camino Del Rio S Ste 210

San Diego, CA 92108

(619) 640-5555

Provider ID: 278396

License: G55454

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92120

Scott, Robert MD

6719 Alvarado Rd Ste 200

San Diego, CA 92120

(619) 229-3932

Provider ID: 119955

License: G73573

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Physicians Assistant

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 184

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

CARLSBAD

92011

Burney, Melissa PA

6010 Hidden Valley Rd Ste 200

Carlsbad, CA 92011

(760) 631-3000

Provider ID: 277535

License: PA58612

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Heinen, John PA

6010 Hidden Valley Rd Ste 200

Carlsbad, CA 92011

(760) 631-3000

Provider ID: 241051

License: PA10565

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Hermanson, Kathleen PA

6010 Hidden Valley Rd Ste 200

Carlsbad, CA 92011

(760) 631-3000

Provider ID: 269004

License: PA51880

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Inocelda, Andrew PA

6010 Hidden Valley Rd Ste 200

Carlsbad, CA 92011

(760) 631-3000

Provider ID: 269089

License: PA19207

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

CHULA VISTA

91910

Alicea, Raul PA

450 Fourth Ave Ste 215

Chula Vista, CA 91910

(619) 434-0204

Provider ID: 268631

License: PA54627

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 185

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

should call the provider’s License: PA54404 accessibility needs when there

office to discuss their Credentials and/or board is limited access or when

accessibility needs when there certification: No accessibility indicators are not

is limited access or when Accepting New Members: Yes present.

accessibility indicators are not Hours: M-SA 9AM-5PM

present. PTA: No 91911 Other Language: Arabic,

Russian, Spanish Macasadia, Marites PA

Holm, Tyler PA Cultural Competency: NR 752 Medical Center Ct Ste 210

480 Fourth Ave Ste 501 Accessibility: B; Members Chula Vista, CA 91911

Chula Vista, CA 91910 should call the provider’s (619) 656-0206

(619) 425-9510 office to discuss their Provider ID: 268788

Provider ID: 241021 accessibility needs when there License: PA15254

License: PA55864 is limited access or when Credentials and/or board

Credentials and/or board accessibility indicators are not certification: No

certification: No present. Accepting New Members: Yes

Accepting New Members: Yes Hours: M-SA 9AM-5PM

Hours: M-SA 9AM-5PM PTA: No

PTA: No Silver, Nikki PA Cultural Competency: NR

Cultural Competency: NR 480 Fourth Ave Ste 501 Accessibility: B; Members

Accessibility: B; Members Chula Vista, CA 91910 should call the provider’s

should call the provider’s (619) 425-9510 office to discuss their

office to discuss their Provider ID: 242650 accessibility needs when there

accessibility needs when there License: PA55325 is limited access or when

is limited access or when Credentials and/or board accessibility indicators are not

accessibility indicators are not certification: No present.

present. Accepting New Members: Yes

Hours: M-SA 9AM-5PM 91914 PTA: No

La Berge-inda, Priscilla PA Other Language: Spanish Solai, Radha PA

450 Fourth Ave Ste 215 Cultural Competency: NR 890 Eastlake Pkwy Ste 205

Chula Vista, CA 91910 Accessibility: B; Members Chula Vista, CA 91914

(619) 434-0204 should call the provider’s (619) 482-0300

Provider ID: 265072 office to discuss their Provider ID: 247295

License: PA54899

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 186

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Vargas, Christopher PA

2452 Fenton St Ste C203

Chula Vista, CA 91914

(619) 600-5309

Provider ID: 268744

License: PA55263

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

EL CAJON

92020

La Berge-inda, Priscilla PA

328 Highland Ave # 200

El Cajon, CA 92020

(619) 930-9404

Provider ID: 265073

License: PA54404

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Russian, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ENCINITAS

92024

Blasic, Vanessa PA

320 Santa Fe Dr Ste 108

Encinitas, CA 92024

(760) 436-4558

Provider ID: 269274

License: PA54781

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Dougherty, Clara PA

320 Santa Fe Dr Ste 108

Encinitas, CA 92024

(760) 436-4558

Provider ID: 269171

License: PA17439

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 187

Page 210: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Norman, Stacy PA

477 N El Camino Real Ste D308

Encinitas, CA 92024

(760) 436-2300

Provider ID: 243430

License: PA17505

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Vanetsky, Gary PA

477 N El Camino Real Ste D308

Encinitas, CA 92024

(760) 436-2300

Provider ID: 269152

License: PA15456

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ESCONDIDO

92025

Ross, Anne PA

425 N Date St

Escondido, CA 92025

(760) 737-2035

Provider ID: 269221

License: PA53359

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92029

Chatfield, Alexandra PA

1955 Citracado Pkwy Ste 200

Escondido, CA 92029

(760) 743-4789

Provider ID: 276716

License: PA57107

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Flores, Ariane-jane PA

1955 Citracado Pkwy Ste 302

Escondido, CA 92029

(760) 743-5111

Provider ID: 241659

License: PA56330

Credentials and/or board

certification: No

Accepting New Members: Yes

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 188

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Inocelda, Andrew PA

1955 Citracado Pkwy Ste 102

Escondido, CA 92029

(760) 631-3000

Provider ID: 269090

License: PA19207

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

FALLBROOK

92028

Sering, Malia PA

1309 S Mission Rd Ste A

Fallbrook, CA 92028

(760) 728-7546

Provider ID: 269279

License: PA19459

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA JOLLA

92037

Blasic, Vanessa PA

9850 Genesee Ave Ste 440

La Jolla, CA 92037

(858) 453-5944

Provider ID: 269273

License: PA54781

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Dougherty, Clara PA

9850 Genesee Ave Ste 440

La Jolla, CA 92037

(858) 453-9944

Provider ID: 269170

License: PA17439

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA MESA

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 189

Page 212: 2021 Direktoryo ng Provider at Parmasya Blue Shield

112

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

91942

Barker, Scott PA

5565 Grossmont Center Dr Ste

La Mesa, CA 91942

(619) 465-0083

Provider ID: 269071

License: PA22121

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Elo, Kristin PA

5555 Grossmont Center Dr

La Mesa, CA 91942

(619) 644-3030

Provider ID: 241862

License: PA19305

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Holm, Tyler PA

8851 Center Dr Ste 601

La Mesa, CA 91942

(619) 441-9811

Provider ID: 241022

License: PA55864

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Keyes, Amy PA

5565 Grossmont Center Dr Ste

101

La Mesa, CA 91942

(619) 464-3353

Provider ID: 247011

License: PA56805

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Raymond, Alain PA

8851 Center Dr Ste 505

La Mesa, CA 91942

(619) 461-3880

Provider ID: 269057

License: PA21466

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: French

Cultural Competency: NR

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 190

Page 213: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Sacknoff, Stefanie PA

5555 Grossmont Center Dr

La Mesa, CA 91942

(619) 644-3030

Provider ID: 268946

License: PA51280

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Suna Sitto, Moheen PA

7051 Alvarado Rd Ste 101

La Mesa, CA 91942

(619) 625-1144

Provider ID: 269776

License: PA22855

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Wray, Amy PA

5555 Grossmont Center Dr

La Mesa, CA 91942

(619) 644-3030

Provider ID: 268840

License: PA17578

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

NATIONAL CITY

91950

Macasadia, Marites PA

610 Euclid Ave Ste 302

National City, CA 91950

(619) 527-7700

Provider ID: 268787

License: PA15254

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

POWAY

92064

Chatfield, Alexandra PA

15611 Pomerado Rd Ste 525

Poway, CA 92064

(858) 485-0050

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 191

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Provider ID: 276715

License: PA57107

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Grindle, Silvia PA

13525 Midland Rd Ste F

Poway, CA 92064

(858) 486-9100

Provider ID: 269926

License: PA21499

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Huang, Stephanie PA

15611 Pomerado Rd Ste 505

Poway, CA 92064

(760) 631-3000

Provider ID: 268025

License: PA21008

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Huang, Stephanie PA

15721 Pomerado Rd

Poway, CA 92064

(760) 631-3000

Provider ID: 269352

License: PA21008

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92103

Beale, Evan PA

4060 4th Ave Ste 415

San Diego, CA 92103

(619) 298-9809

Provider ID: 271081

License: PA55344

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 192

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Nelms, Michael PA

4060 4th Ave Ste 415

San Diego, CA 92103

(619) 298-9809

Provider ID: 242771

License: PA14379

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92111

Ceriale, Christopher PA

7526 Clairemont Mesa Blvd

San Diego, CA 92111

(888) 743-7526

Provider ID: 269867

License: PA54651

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Rai, Georgina PA

7526 Clairemont Mesa Blvd

San Diego, CA 92111

(858) 743-7526

Provider ID: 270053

License: PA54629

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92121

Beale, Evan PA

9339 Genesee Ave Ste 350

San Diego, CA 92121

(858) 454-4300

Provider ID: 271080

License: PA55344

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Holm, Tyler PA

9333 Genesee Ave Ste 350 A

San Diego, CA 92121

(858) 455-6460

Provider ID: 241020

License: PA55864

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 193

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Longobardo, Francesca PA

9333 Genesee Ave Ste 350a

San Diego, CA 92121

(858) 455-6460

Provider ID: 241372

License: PA52844

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Silver, Nikki PA

9333 Genesee Ave Ste 350

San Diego, CA 92121

(858) 455-6460

Provider ID: 242649

License: PA55325

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92123

Daneshvar, Abraham PA

9610 Granite Ridge Dr Ste B

San Diego, CA 92123

(858) 558-8150

Provider ID: 271004

License: PA52905

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Turkish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Negley, Joelle PA

9610 Granite Ridge Dr Ste B

San Diego, CA 92123

(619) 461-3880

Provider ID: 269821

License: PA52553

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN MARCOS

92069

Sering, Malia PA

838 Nordahl Rd Ste 250

San Marcos, CA 92069

(760) 738-7600

Provider ID: 269280

License: PA19459

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 194

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SANTEE

92071

Cool, Jay PA

120 Town Center Pkwy

Santee, CA 92071

(619) 445-6200

Provider ID: 241374

License: PA53135

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

VISTA

92084

Wallace, Stephanie PA

1000 Vale Terrace Dr

Vista, CA 92084

(760) 631-5000

Provider ID: 239770

License: PA19629

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Podiatrist

CHULA VISTA

91910

Chisholm, John DPM

345 F St Ste 100

Chula Vista, CA 91910

(619) 427-3481

Provider ID: 268440

License: DPM3431

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Russian,

Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Canaba, Yvette MD

345 F St Ste 100

Chula Vista, CA 91910

(619) 427-3481

Provider ID: 268469

License: DPM5496

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 195

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Davidson, John DPM

345 F St Ste 100

Chula Vista, CA 91910

(619) 427-3481

Provider ID: 129545

License: DPM5418

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Puccinelli, Alayna DPM

345 F St Ste 100

Chula Vista, CA 91910

(619) 427-3481

Provider ID: 268461

License: DPM5349

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Russian,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Xu, Dixon DPM

345 F St Ste 100

Chula Vista, CA 91910

(619) 427-3481

Provider ID: 277917

License: DPM5596

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Mandarin,

Shanghaiese, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

EL CAJON

92019

Vallone, Melchior DPM

5442 Sycuan Rd

El Cajon, CA 92019

(619) 445-0707

Provider ID: 204673

License: DPM2201

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92020

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 196

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Farmer, Steven DPM

855 E Madison Ave

El Cajon, CA 92020

(619) 440-2751

Provider ID: 268976

License: DPM2895

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ESCONDIDO

92025

Farmer, Steven DPM

728 E Valley Pkwy

Escondido, CA 92025

(760) 737-6900

Provider ID: 268975

License: DPM2895

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Negron, Ricardo DPM

1001 E Grand Ave

Escondido, CA 92025

(858) 218-3000

Provider ID: 274646

License: DPM5260

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA MESA

91941

Vallone, Melchior DPM

5129 Garfield St

La Mesa, CA 91941

(619) 465-3200

Provider ID: 26555

License: DPM2201

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

NATIONAL CITY

91950

Ahmed, Aisha DPM

1428 Highland Ave

National City, CA 91950

(844) 200-2426

Provider ID: 243131

License: DPM5369

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 197

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Other Language: Hindi,

Spanish, Urdu

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Atmar, Akmal DPM

2345 E 8th St Ste 105

National City, CA 91950

(929) 287-4511

Provider ID: 269784

License: DPM5295

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Persian, Urdu

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Chisholm, John DPM

610 Euclid Ave Ste 301

National City, CA 91950

(619) 292-2493

Provider ID: 268441

License: DPM3431

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Russian,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Davidson, John DPM

610 Euclid Ave Ste 301

National City, CA 91950

(619) 292-2493

Provider ID: 129542

License: DPM5418

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92104

Forg, Patricia DPM

3989 32nd St

San Diego, CA 92104

(619) 283-2097

Provider ID: 270062

License: DPM3775

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 198

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

certification: No accessibility needs when there

Accepting New Members: Yes is limited access or when92115 Hours: M-SA 9AM-5PM accessibility indicators are not

Foygelman, Aleksandr DPM PTA: No present.

4440 Euclid Ave Cultural Competency: NR

San Diego, CA 92115 Accessibility: B; Members

(619) 281-3338 should call the provider’s

Provider ID: 270221 office to discuss their

License: DPM4387 accessibility needs when there

CARLSBAD

92011

Alasantro, Lori PhDCredentials and/or board is limited access or when 6010 Hidden Valley Rd Ste 200certification: No accessibility indicators are not Carlsbad, CA 92011Accepting New Members: Yes present. (760) 631-3000Hours: M-SA 9AM-5PM

Psychologist

ALPINE

91901

Provider ID: 269067PTA: No License: PSY25817Other Language: Armenian, Credentials and/or boardBulgarian, Hebrew, Russian, certification: NoSpanish, Ukrainian Accepting New Members: YesCultural Competency: NR Hours: M-SA 9AM-5PMAccessibility: B; Members

Barmak, Shant PSYD PTA: Noshould call the provider’s 1620 Alpine Blvd Cultural Competency: NRoffice to discuss their Alpine, CA 91901 Accessibility: B; Members accessibility needs when there (619) 445-6200 should call the provider’sis limited access or when Provider ID: 129026 office to discuss theiraccessibility indicators are not License: PSY24998 accessibility needs when therepresent. Credentials and/or board is limited access or when

certification: No accessibility indicators are not92121

Accepting New Members: Yes present.

Hours: M-SA 9AM-5PMCollins, Michael DPM PTA: No9333 Genesee Ave Ste 350a Other Language: Armenian Rosen, Jay PhDSan Diego, CA 92121 Cultural Competency: NR 6010 Hidden Valley Rd Ste 200(858) 455-6460 Accessibility: B; Members Carlsbad, CA 92011Provider ID: 269866 should call the provider’s (760) 631-3000License: DPM5146 office to discuss their Provider ID: 269010Credentials and/or board

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 199

Page 222: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

License: PSY25093

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

POWAY

92064

Kaup, Allison PhD

15721 Pomerado Rd

Poway, CA 92064

(760) 631-3000

Provider ID: 269382

License: PSY26484

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Rosen, Jay PhD

15721 Pomerado Rd

Poway, CA 92064

(760) 631-3000

Provider ID: 269011

License: PSY25093

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Pulmonary Diseases

CARLSBAD

92011

Hsing, Andrew MD

6010 Hidden Valley Rd Ste 200

Carlsbad, CA 92011

(760) 631-3000

Provider ID: 125301

License: A127271

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

CHULA VISTA

91914

Lira, Jose MD

841 Kuhn Dr Ste 200

Chula Vista, CA 91914

(619) 482-7301

Provider ID: 268769

License: A33913

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 200

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Lozano, Martha MD

841 Kuhn Dr Ste 200

Chula Vista, CA 91914

(619) 363-4000

Provider ID: 269322

License: A48551

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ESCONDIDO

92025

Bender, Frank MD

488 E Valley Pkwy Ste 211

Escondido, CA 92025

(760) 489-1458

Provider ID: 53988

License: G33933

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Popper, Steven MD

488 E Valley Pkwy Ste 211

Escondido, CA 92025

(760) 489-1458

Provider ID: 204438

License: A127156

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Popper, Steven MD

488 E Valley Pkwy Ste 201

Escondido, CA 92025

(760) 489-1458

Provider ID: 276725

License: A127156

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Trestman, Kenneth MD

488 E Valley Pkwy Ste 211

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 201

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Escondido, CA 92025

(760) 489-1458

Provider ID: 269147

License: G69663

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

POWAY

92064

Bender, Frank MD

15611 Pomerado Rd Ste 580

Poway, CA 92064

(000) 000-0000

Provider ID: 270195

License: G33933

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Otoshi, James MD

15611 Pomerado Rd Ste 400

Poway, CA 92064

(760) 489-1458

Provider ID: 274767

License: G27763

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Popper, Steven MD

15611 Pomerado Rd Ste 400

Poway, CA 92064

(858) 675-3100

Provider ID: 129606

License: A127156

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Trestman, Kenneth MD

15611 Pomerado Rd Ste 400

Poway, CA 92064

(858) 675-3100

Provider ID: 269146

License: G69663

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 202

Page 225: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92115

Le, Huan MD

5507 El Cajon Blvd # C

San Diego, CA 92115

(619) 582-1448

Provider ID: 27358

License: A76373

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: French,

Spanish, Vietnamese

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Radiation Oncology

CHULA VISTA

91911

Coleman, Lori MD

769 Medical Center Ct

Chula Vista, CA 91911

(619) 502-5851

Provider ID: 206393

License: G78635

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Dewitt, Kelly MD

769 Medical Center Ct

Chula Vista, CA 91911

(619) 502-5851

Provider ID: 220043

License: A74873

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Jabbari, Siavash MD

751 Medical Center Ct

Chula Vista, CA 91911

(619) 502-5851

Provider ID: 204860

License: A99269

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Farsi

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 203

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Other Language: Kannada, Volpp, Paul MD

Jabbari, Siavash MD Spanish 769 Medical Center Ct

769 Medical Center Ct Cultural Competency: NR Chula Vista, CA 91911

Chula Vista, CA 91911 Accessibility: B; Members (619) 502-5851

(619) 502-5851 should call the provider’s Provider ID: 221102

Provider ID: 268783 office to discuss their License: A86307

License: A99269 accessibility needs when there Credentials and/or board

Credentials and/or board is limited access or when certification: No

certification: No accessibility indicators are not Accepting New Members: Yes

Accepting New Members: Yes present. Hours: M-SA 9AM-5PM

Hours: M-SA 9AM-5PM PTA: No

PTA: Yes Other Language: Spanish

Other Language: Farsi Uhl, Barry MD Cultural Competency: NR

Cultural Competency: NR 769 Medical Center Ct Accessibility: B; Members

Accessibility: B; Members Chula Vista, CA 91911 should call the provider’s

should call the provider’s (619) 502-5851 office to discuss their

office to discuss their Provider ID: 243527 accessibility needs when there

accessibility needs when there License: A71969 is limited access or when

is limited access or when Credentials and/or board accessibility indicators are not

accessibility indicators are not certification: No present.

present. Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No Weinstein, Geoffrey MD

Pejavar, Sunanda MD Other Language: Spanish 769 Medical Center Ct

769 Medical Center Ct Cultural Competency: NR Chula Vista, CA 91911

Chula Vista, CA 91911 Accessibility: B; Members (619) 502-5851

(619) 502-5851 should call the provider’s Provider ID: 200538

Provider ID: 221074 office to discuss their License: A54109

License: A103733 accessibility needs when there Credentials and/or board

Credentials and/or board is limited access or when certification: No

certification: No accessibility indicators are not Accepting New Members: Yes

Accepting New Members: Yes present. Hours: M-SA 9AM-5PM

Hours: M-SA 9AM-5PM PTA: No

PTA: No Other Language: Spanish

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 204

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Zentner, Phillip MD

769 Medical Center Ct

Chula Vista, CA 91911

(619) 502-5851

Provider ID: 204848

License: G83516

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ESCONDIDO

92025

Fuller, Donald MD

701 E Grand Ave Ste 200

Escondido, CA 92025

(760) 839-7370

Provider ID: 269237

License: G62532

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Ijaz, Tahir MD

701 E Grand Ave Ste 200

Escondido, CA 92025

(760) 839-7370

Provider ID: 269244

License: A52748

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Shirazi, Reza MD

701 E Grand Ave Ste 200

Escondido, CA 92025

(760) 839-7370

Provider ID: 269248

License: A95800

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Farsi,

Persian, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92029

Coleman, Lori MD

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 205

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

2125 Citracado Pkwy Ste 110 Accessibility: B; Members (760) 739-3371

Escondido, CA 92029 should call the provider’s Provider ID: 221076

(760) 735-7800 office to discuss their License: A103733

Provider ID: 221090 accessibility needs when there Credentials and/or board

License: G78635 is limited access or when certification: No

Credentials and/or board accessibility indicators are not Accepting New Members: Yes

certification: No present. Hours: M-SA 9AM-5PM

Accepting New Members: Yes PTA: No

Hours: M-SA 9AM-5PM Other Language: Kannada,

PTA: No Jabbari, Siavash MD Spanish

Other Language: Spanish 2125 Citracado Pkwy Ste 110 Cultural Competency: NR

Cultural Competency: NR Escondido, CA 92029 Accessibility: B; Members

Accessibility: B; Members (760) 739-3371 should call the provider’s

should call the provider’s Provider ID: 268786 office to discuss their

office to discuss their License: A99269 accessibility needs when there

accessibility needs when there Credentials and/or board is limited access or when

is limited access or when certification: No accessibility indicators are not

accessibility indicators are not Accepting New Members: Yes present.

present. Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi Uhl, Barry MD

Dewitt, Kelly MD Cultural Competency: NR 2125 Citracado Pkwy Ste 110

2125 Citracado Pkwy Ste 110 Accessibility: B; Members Escondido, CA 92029

Escondido, CA 92029 should call the provider’s (760) 739-3371

(760) 739-3371 office to discuss their Provider ID: 243529

Provider ID: 220044 accessibility needs when there License: A71969

License: A74873 is limited access or when Credentials and/or board

Credentials and/or board accessibility indicators are not certification: No

certification: No present. Accepting New Members: Yes

Accepting New Members: Yes Hours: M-SA 9AM-5PM

Hours: M-SA 9AM-5PM PTA: No

PTA: No Pejavar, Sunanda MD Other Language: Spanish

Other Language: Spanish 2125 Citracado Pkwy Ste 110 Cultural Competency: NR

Cultural Competency: NR Escondido, CA 92029 Accessibility: B; Members

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 206

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Volpp, Paul MD

2125 Citracado Pkwy Ste 110

Escondido, CA 92029

(760) 735-7800

Provider ID: 221103

License: A86307

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Weinstein, Geoffrey MD

2125 Citracado Pkwy Ste 110

Escondido, CA 92029

(760) 739-3371

Provider ID: 220041

License: A54109

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Zentner, Phillip MD

2125 Citracado Pkwy Ste 110

Escondido, CA 92029

(760) 735-7800

Provider ID: 221092

License: G83516

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA JOLLA

92093

Mayadev, Jyoti MD

3855 Health Sciences Dr

La Jolla, CA 92093

(916) 734-8269

Provider ID: 269884

License: A109372

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Mell, Loren MD

3855 Health Sciences Dr

La Jolla, CA 92093

(619) 543-3405

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 207

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Provider ID: 269944

License: A104704

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Murphy, Kevin MD

3855 Health Sciences Dr

La Jolla, CA 92093

(858) 822-6046

Provider ID: 269865

License: A82350

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Macewan, Iain MD

3855 Health Sciences Dr

La Jolla, CA 92093

(858) 822-4048

Provider ID: 255729

License: A129079

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Rose, Brent MD

3855 Health Sciences Dr

La Jolla, CA 92093

(619) 341-3899

Provider ID: 269874

License: A142735

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Sanghvi, Parag MD

3855 Health Sciences Dr

La Jolla, CA 92093

(619) 230-0400

Provider ID: 270038

License: A105184

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Gujarati,

Hindi, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 208

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Sharabi, Andrew MD

3855 Health Sciences Dr

La Jolla, CA 92093

(619) 543-1899

Provider ID: 269862

License: A136977

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Simpson, Daniel MD

3855 Health Sciences Dr

La Jolla, CA 92093

(858) 822-6040

Provider ID: 269852

License: A118377

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA MESA

91942

Coleman, Lori MD

5555 Grossmont Center Dr

La Mesa, CA 91942

(619) 644-4500

Provider ID: 221089

License: G78635

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Dewitt, Kelly MD

5555 Grossmont Center Dr

La Mesa, CA 91942

(619) 740-4500

Provider ID: 206385

License: A74873

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Jabbari, Siavash MD

5555 Grossmont Center Dr

La Mesa, CA 91942

(619) 740-4500

Provider ID: 268785

License: A99269

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 209

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Cultural Competency: NR 5555 Grossmont Center Dr Accessibility: B; Members

Accessibility: B; Members La Mesa, CA 91942 should call the provider’s

should call the provider’s (619) 740-4500 office to discuss their

office to discuss their Provider ID: 204684 accessibility needs when there

accessibility needs when there License: A71969 is limited access or when

is limited access or when Credentials and/or board accessibility indicators are not

accessibility indicators are not certification: No present.

present. Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes Weinstein, Geoffrey MD

Pejavar, Sunanda MD Other Language: Spanish 5555 Grossmont Center Dr

5555 Grossmont Center Dr Cultural Competency: NR La Mesa, CA 91942

La Mesa, CA 91942 Accessibility: B; Members (619) 740-4500

(619) 740-4500 should call the provider’s Provider ID: 220040

Provider ID: 221075 office to discuss their License: A54109

License: A103733 accessibility needs when there Credentials and/or board

Credentials and/or board is limited access or when certification: No

certification: No accessibility indicators are not Accepting New Members: Yes

Accepting New Members: Yes present. Hours: M-SA 9AM-5PM

Hours: M-SA 9AM-5PM PTA: No

PTA: No Other Language: Spanish

Other Language: Kannada, Volpp, Paul MD Cultural Competency: NR

Spanish 5555 Grossmont Center Dr Accessibility: B; Members

Cultural Competency: NR La Mesa, CA 91942 should call the provider’s

Accessibility: B; Members (619) 740-4500 office to discuss their

should call the provider’s Provider ID: 221104 accessibility needs when there

office to discuss their License: A86307 is limited access or when

accessibility needs when there Credentials and/or board accessibility indicators are not

is limited access or when certification: No present.

accessibility indicators are not Accepting New Members: Yes

present. Hours: M-SA 9AM-5PM

PTA: No Zentner, Phillip MD

Other Language: Spanish 5555 Grossmont Center Dr

Uhl, Barry MD Cultural Competency: NR La Mesa, CA 91942

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 210

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

(619) 740-8499

Provider ID: 221094

License: G83516

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92101

Fuller, Donald MD

2466 1st Ave # B

San Diego, CA 92101

(619) 230-0400

Provider ID: 269236

License: G62532

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92103

Ijaz, Tahir MD

3366 5th Ave

San Diego, CA 92103

(619) 230-0400

Provider ID: 269246

License: A52748

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Shirazi, Reza MD

3366 5th Ave

San Diego, CA 92103

(619) 230-0400

Provider ID: 269250

License: A95800

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Persian, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92121

Sanghvi, Parag MD

9730 Summers Ridge Rd

San Diego, CA 92121

(858) 549-7400

Provider ID: 270040

License: A105184

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Gujarati,

Hindi, Spanish

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 211

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92123

Coleman, Lori MD

3075 Health Center Dr

San Diego, CA 92123

(858) 939-5010

Provider ID: 221091

License: G78635

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Dewitt, Kelly MD

3075 Health Center Dr

San Diego, CA 92123

(858) 939-5010

Provider ID: 220045

License: A74873

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Fuller, Donald MD

5395 Ruffin Rd Ste 103

San Diego, CA 92123

(858) 505-4100

Provider ID: 269238

License: G62532

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Ijaz, Tahir MD

5395 Ruffin Rd Ste 103

San Diego, CA 92123

(858) 505-4100

Provider ID: 269245

License: A52748

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Jabbari, Siavash MD

3075 Health Center Dr # 0

Level

San Diego, CA 92123

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 212

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

(858) 939-5010 should call the provider’s (858) 939-5010

Provider ID: 268784 office to discuss their Provider ID: 243528

License: A99269 accessibility needs when there License: A71969

Credentials and/or board is limited access or when Credentials and/or board

certification: No accessibility indicators are not certification: No

Accepting New Members: Yes present. Accepting New Members: Yes

Hours: M-SA 9AM-5PM Hours: M-SA 9AM-5PM

PTA: No PTA: No

Other Language: Farsi Shirazi, Reza MD Other Language: Spanish

Cultural Competency: NR 5395 Ruffin Rd Ste 103 Cultural Competency: NR

Accessibility: B; Members San Diego, CA 92123 Accessibility: B; Members

should call the provider’s (858) 505-4100 should call the provider’s

office to discuss their Provider ID: 269249 office to discuss their

accessibility needs when there License: A95800 accessibility needs when there

is limited access or when Credentials and/or board is limited access or when

accessibility indicators are not certification: No accessibility indicators are not

present. Accepting New Members: Yes present.

Hours: M-SA 9AM-5PM

PTA: No

Pejavar, Sunanda MD Other Language: Farsi, Volpp, Paul MD

3075 Health Center Dr Persian, Spanish 3075 Health Center Dr

San Diego, CA 92123 Cultural Competency: NR San Diego, CA 92123

(858) 939-5010 Accessibility: B; Members (858) 939-5010

Provider ID: 221077 should call the provider’s Provider ID: 221105

License: A103733 office to discuss their License: A86307

Credentials and/or board accessibility needs when there Credentials and/or board

certification: No is limited access or when certification: No

Accepting New Members: Yes accessibility indicators are not Accepting New Members: Yes

Hours: M-SA 9AM-5PM present. Hours: M-SA 9AM-5PM

PTA: No PTA: No

Other Language: Kannada, Other Language: Spanish

Spanish Uhl, Barry MD Cultural Competency: NR

Cultural Competency: NR 3075 Health Center Dr Accessibility: B; Members

Accessibility: B; Members San Diego, CA 92123 should call the provider’s

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 213

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

office to discuss their License: G83516 accessibility needs when there

accessibility needs when there Credentials and/or board is limited access or when

is limited access or when certification: No accessibility indicators are not

accessibility indicators are not Accepting New Members: Yes present.

present. Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish Hattangadi Gluth, Jona MD

Weinstein, Geoffrey MD Cultural Competency: NR 16918 Dove Canyon Rd Ste

3075 Health Center Dr Accessibility: B; Members 103

San Diego, CA 92123 should call the provider’s San Diego, CA 92127

(858) 939-5010 office to discuss their (559) 447-4949

Provider ID: 220039 accessibility needs when there Provider ID: 254496

License: A54109 is limited access or when License: A122308

Credentials and/or board accessibility indicators are not Credentials and/or board

certification: No present. certification: No

Accepting New Members: Yes Accepting New Members: Yes

Hours: M-SA 9AM-5PM 92127 Hours: M-SA 9AM-5PM

PTA: No PTA: No

Other Language: Spanish Bruggeman, Andrew MD Cultural Competency: NR

Cultural Competency: NR 16918 Dove Canyon Rd Ste Accessibility: B; Members

Accessibility: B; Members 103 should call the provider’s

should call the provider’s San Diego, CA 92127 office to discuss their

office to discuss their (858) 649-5100 accessibility needs when there

accessibility needs when there Provider ID: 271007 is limited access or when

is limited access or when License: A126549 accessibility indicators are not

accessibility indicators are not Credentials and/or board present.

present. certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM Hoopes, David MD

Zentner, Phillip MD PTA: No 16918 Dove Canyon Rd Ste

3075 Health Center Dr Cultural Competency: NR 103

San Diego, CA 92123 Accessibility: B; Members San Diego, CA 92127

(858) 969-5010 should call the provider’s (559) 447-4949

Provider ID: 221093 office to discuss their Provider ID: 269725

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 214

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

License: C128063 accessibility needs when there License: A82350

Credentials and/or board is limited access or when Credentials and/or board

certification: No accessibility indicators are not certification: No

Accepting New Members: Yes present. Accepting New Members: Yes

Hours: M-SA 9AM-5PM Hours: M-SA 9AM-5PM

PTA: No PTA: No

Other Language: Spanish Mell, Loren MD Other Language: Spanish

Cultural Competency: NR 16918 Dove Canyon Rd Ste Cultural Competency: NR

Accessibility: B; Members 103 Accessibility: B; Members

should call the provider’s San Diego, CA 92127 should call the provider’s

office to discuss their (559) 447-4949 office to discuss their

accessibility needs when there Provider ID: 255893 accessibility needs when there

is limited access or when License: A104704 is limited access or when

accessibility indicators are not Credentials and/or board accessibility indicators are not

present. certification: No present.

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

Mayadev, Jyoti MD PTA: No Macewan, Iain MD

16918 Dove Canyon Rd Ste Cultural Competency: NR 16918 Dove Canyon Rd Ste

103 Accessibility: B; Members 103

San Diego, CA 92127 should call the provider’s San Diego, CA 92127

(858) 649-5100 office to discuss their (858) 649-5100

Provider ID: 256153 accessibility needs when there Provider ID: 255730

License: A109372 is limited access or when License: A129079

Credentials and/or board accessibility indicators are not Credentials and/or board

certification: No present. certification: No

Accepting New Members: Yes Accepting New Members: Yes

Hours: M-SA 9AM-5PM Hours: M-SA 9AM-5PM

PTA: No Murphy, Kevin MD PTA: No

Other Language: Spanish 16918 Dove Canyon Rd Ste Cultural Competency: NR

Cultural Competency: NR 103 Accessibility: B; Members

Accessibility: B; Members San Diego, CA 92127 should call the provider’s

should call the provider’s (858) 649-5100 office to discuss their

office to discuss their Provider ID: 242618 accessibility needs when there

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 215

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

is limited access or when

accessibility indicators are not

present.

Rose, Brent MD

16918 Dove Canyon Rd Ste

103

San Diego, CA 92127

(858) 649-5100

Provider ID: 256307

License: A142735

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Sandhu, Ajay MD

16918 Dove Canyon Rd Ste

103

San Diego, CA 92127

(559) 447-4949

Provider ID: 247978

License: A69947

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Hindi,

Punjabi

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Sanghvi, Parag MD

16918 Dove Canyon Rd

San Diego, CA 92127

(858) 309-6585

Provider ID: 248043

License: A105184

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Gujarati,

Hindi, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Sanghvi, Parag MD

16918 Dove Canyon Rd Ste

103

San Diego, CA 92127

(858) 309-6585

Provider ID: 270039

License: A105184

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Gujarati,

Hindi, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Sharabi, Andrew MD

16918 Dove Canyon Rd Ste

103

San Diego, CA 92127

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 216

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

(858) 649-5100

Provider ID: 257024

License: A136977

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Simpson, Daniel MD

16918 Dove Canyon Rd Ste

103

San Diego, CA 92127

(858) 649-5100

Provider ID: 256193

License: A118377

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Radiology Diagnostic X-ray

CHULA VISTA

91910

Allen, Derrick MD

333 H St Ste 1095

Chula Vista, CA 91910

(619) 409-9119

Provider ID: 268362

License: A69840

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Buckley, David MD

333 H St Ste 1095

Chula Vista, CA 91910

(858) 658-6500

Provider ID: 243267

License: G57383

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Sun, Alex MD

435 H St Ste 1

Chula Vista, CA 91910

(619) 543-2218

Provider ID: 268634

License: A133334

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 217

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ENCINITAS

92024

Allen, Derrick MD

477 N El Camino Real Ste A102

Encinitas, CA 92024

(760) 452-7150

Provider ID: 268358

License: A69840

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Buckley, David MD

477 N El Camino Real Ste A102

Encinitas, CA 92024

(760) 452-7150

Provider ID: 243264

License: G57383

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA JOLLA

92037

Allen, Derrick MD

4150 Regents Park Row Ste 195

La Jolla, CA 92037

(858) 622-6464

Provider ID: 268361

License: A69840

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Buckley, David MD

4150 Regents Park Row Ste 195

La Jolla, CA 92037

(858) 622-6464

Provider ID: 243265

License: G57383

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA MESA

91942

Liu, Jenna MD

5555 Grossmont Center Dr

La Mesa, CA 91942

(619) 461-1830

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 218

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Provider ID: 269009

License: A91263

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Naumann, Michael MD

8881 Fletcher Pkwy Ste 102

La Mesa, CA 91942

(619) 461-1830

Provider ID: 269664

License: A116596

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Naumann, Michael MD

8860 Center Dr Ste 100

La Mesa, CA 91942

(619) 460-2770

Provider ID: 269665

License: A116596

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Sun, Alex MD

5555 Grossmont Center Dr

La Mesa, CA 91942

(619) 740-4008

Provider ID: 268633

License: A133334

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

OCEANSIDE

92056

Allen, Derrick MD

3601 Vista Way

Oceanside, CA 92056

(760) 631-7505

Provider ID: 268360

License: A69840

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 219

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

POWAY

92064

Allen, Derrick MD

12620 Monte Vista Rd Ste A

Poway, CA 92064

(858) 487-9729

Provider ID: 268359

License: A69840

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Buckley, David MD

12620 Monte Vista Rd Ste A

Poway, CA 92064

(858) 487-9729

Provider ID: 243262

License: G57383

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92103

Allen, Derrick MD

4077 5th Ave

San Diego, CA 92103

(888) 685-4016

Provider ID: 268355

License: A69840

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Buckley, David MD

150 W Washington St

San Diego, CA 92103

(858) 658-6500

Provider ID: 243260

License: G57383

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Buckley, David MD

550 Washington St Ste 200

San Diego, CA 92103

(619) 260-7225

Provider ID: 243268

License: G57383

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 220

Page 243: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Sun, Alex MD

200 W Arbor Dr

San Diego, CA 92103

(619) 543-2218

Provider ID: 268632

License: A133334

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92113

Allen, Derrick MD

1809 National Ave Ste 2104

San Diego, CA 92113

should call the provider’s

office to discuss their

(858) 658-6500

Provider ID: 268354

accessibility needs when there

is limited access or when

License: A69840 accessibility indicators are not

Credentials and/or board

certification: No

present.

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Buckley, David MD

6386 Alvarado Ct Ste 121

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

San Diego, CA 92120

(619) 229-2299

Provider ID: 243266

office to discuss their License: G57383

accessibility needs when there

is limited access or when

Credentials and/or board

certification: No

accessibility indicators are not

present.

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

92120

Allen, Derrick MD

6386 Alvarado Ct Ste 121

San Diego, CA 92120

(619) 229-2299

Provider ID: 268357

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

License: A69840

Credentials and/or board

certification: No

accessibility indicators are not

present.

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Ihs Radiology Medical Group

Inc,

Cultural Competency: NR

Accessibility: B; Members

6386 Alvarado Ct Ste 121

San Diego, CA 92120

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 221

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(619) 229-2299

NPI#: 1497148456

Provider ID: 200459

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92123

Buckley, David MD

3939 Ruffin Rd Ste 102

San Diego, CA 92123

(858) 658-6500

Provider ID: 243261

License: G57383

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SANTEE

92071

Naumann, Michael MD

9640 Mission Gorge Rd Ste H

Santee, CA 92071

(619) 258-8552

Provider ID: 269663

License: A116596

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Radiology Diagnostic

CHULA VISTA

91910

Tiefenbrun, Jonathan MD

340 4th Ave Ste 4

Chula Vista, CA 91910

(619) 427-1144

Provider ID: 66135

License: G85951

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: French,

Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA MESA

91942

Mortezaie, Alan MD

5555 Grossmont Center Dr

La Mesa, CA 91942

(661) 326-9600

Provider ID: 268883

License: A116100

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 222

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PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Tiefenbrun, Jonathan MD

8851 Center Dr Ste 505

La Mesa, CA 91942

(619) 461-3880

Provider ID: 268966

License: G85951

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: French,

Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Radiology

CHULA VISTA

91910

Doemeny, John MD

333 H St Ste 1095

Chula Vista, CA 91910

(858) 658-6500

Provider ID: 269755

License: G50925

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Franke, Mark MD

333 H St Ste 1095

Chula Vista, CA 91910

(858) 658-6500

Provider ID: 269639

License: A118792

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Lubisich, John MD

333 H St Ste 1095

Chula Vista, CA 91910

(858) 658-6500

Provider ID: 244952

License: G77575

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 223

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Moffit, Brian MD Cultural Competency: NR Doemeny, John MD

333 H St Ste 1095

Chula Vista, CA 91910

(858) 658-6500

Provider ID: 269533

License: G51551

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Tena, Rowena MD

333 H St Ste 1095

Chula Vista, CA 91910

(858) 658-6500

Provider ID: 269829

License: A69607

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

91911

Hawley, Daniel MD

751 Medical Center Ct

Chula Vista, CA 91911

(619) 502-5851

Provider ID: 268857

License: A114748

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ENCINITAS

92024

477 N El Camino Real Ste A102

Encinitas, CA 92024

(760) 452-7150

Provider ID: 269750

License: G50925

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Franke, Mark MD

477 N El Camino Real Ste A102

Encinitas, CA 92024

(760) 452-7150

Provider ID: 269635

License: A118792

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 224

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Moffit, Brian MD

477 N El Camino Real Ste A102

Encinitas, CA 92024

(760) 452-7150

Provider ID: 269524

License: G51551

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Schwartzberg, Ross MD

477 N El Camino Real Ste A102

Encinitas, CA 92024

(760) 452-7150

Provider ID: 245629

License: G72997

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Tena, Rowena MD

477 N El Camino Real Ste 102

Encinitas, CA 92024

(760) 452-7150

Provider ID: 269824

License: A69607

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA JOLLA

92037

Doemeny, John MD

4150 Regents Park Row Ste 195

La Jolla, CA 92037

(858) 622-6464

Provider ID: 269748

License: G50925

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Franke, Mark MD

4150 Regents Park Row Ste 195

La Jolla, CA 92037

(858) 622-6464

Provider ID: 269633

License: A118792

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 225

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Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Moffit, Brian MD

4150 Regents Park Row Ste 195

La Jolla, CA 92037

(858) 622-6464

Provider ID: 269527

License: G51551

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Schwartzberg, Ross MD

4150 Regents Park Row Ste 195

La Jolla, CA 92037

(858) 622-6464

Provider ID: 245630

License: G72997

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Tena, Rowena MD

4150 Regents Park Row Ste 195

La Jolla, CA 92037

(858) 622-6464

Provider ID: 269826

License: A69607

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA MESA

91942

Brannigan, Thomas MD

5555 Grossmont Center Dr

La Mesa, CA 91942

(619) 460-2770

Provider ID: 269041

License: G65789

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 226

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Cultural Competency: NR (508) 295-7271

Chang, Weiling MD Accessibility: B; Members Provider ID: 268900

5555 Grossmont Center Dr should call the provider’s License: C131942

La Mesa, CA 91942 office to discuss their Credentials and/or board

(619) 460-2770 accessibility needs when there certification: No

Provider ID: 269040 is limited access or when Accepting New Members: Yes

License: A90535 accessibility indicators are not Hours: M-SA 9AM-5PM

Credentials and/or board present. PTA: No

certification: No Other Language: Vietnamese

Accepting New Members: Yes Cultural Competency: NR

Hours: M-SA 9AM-5PM Ellison, Jon MD Accessibility: B; Members

PTA: No 5555 Grossmont Center Dr should call the provider’s

Cultural Competency: NR La Mesa, CA 91942 office to discuss their

Accessibility: B; Members (619) 460-2774 accessibility needs when there

should call the provider’s Provider ID: 268993 is limited access or when

office to discuss their License: A117199 accessibility indicators are not

accessibility needs when there Credentials and/or board present.

is limited access or when certification: No

accessibility indicators are not Accepting New Members: Yes

present. Hours: M-SA 9AM-5PM Honowitz, Scott MD

PTA: No 5555 Grossmont Center Dr

Cultural Competency: NR La Mesa, CA 91942

Ellison, Harry MD Accessibility: B; Members (508) 295-7271

5555 Grossmont Center Dr Ste should call the provider’s Provider ID: 268846

1 office to discuss their License: A134287

La Mesa, CA 91942 accessibility needs when there Credentials and/or board

(619) 740-5100 is limited access or when certification: No

Provider ID: 268985 accessibility indicators are not Accepting New Members: Yes

License: G50309 present. Hours: M-SA 9AM-5PM

Credentials and/or board PTA: No

certification: No Cultural Competency: NR

Accepting New Members: Yes Ha, Tuan MD Accessibility: B; Members

Hours: M-SA 9AM-5PM 5555 Grossmont Center Dr should call the provider’s

PTA: No La Mesa, CA 91942 office to discuss their

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 227

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Jacobsen, James MD

8881 Fletcher Pkwy Ste 102

La Mesa, CA 91942

(619) 460-2770

Provider ID: 243974

License: A87878

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Jacobsen, James MD

8860 Center Dr Ste 100

La Mesa, CA 91942

(619) 460-2770

Provider ID: 243975

License: A87878

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Lance, Valentin MD

5555 Grossmont Center Dr

La Mesa, CA 91942

(800) 841-5200

Provider ID: 268974

License: A118759

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Moore, Brian MD

8881 Fletcher Pkwy Ste 102

La Mesa, CA 91942

(619) 460-2770

Provider ID: 243959

License: G68336

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Moore, Brian MD

8860 Center Dr Ste 100

La Mesa, CA 91942

(619) 460-2770

Provider ID: 243960

License: G68336

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 228

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Trout, Tere MD

5555 Grossmont Center Dr

La Mesa, CA 91942

(619) 460-2770

Provider ID: 268982

License: G70276

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Urioste, Alexander MD

8860 Center Dr Ste 100

La Mesa, CA 91942

(619) 460-2770

Provider ID: 269251

License: A78795

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Venkatesh, Vijay MD

8860 Center Dr Ste 100

La Mesa, CA 91942

(619) 740-5100

Provider ID: 269659

License: A94476

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Venkatesh, Vijay MD

8881 Fletcher Pkwy Ste 102

La Mesa, CA 91942

(619) 461-1830

Provider ID: 269660

License: A94476

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Viets, Ryan MD

5555 Grossmont Center Dr

La Mesa, CA 91942

(619) 740-5100

Provider ID: 268951

License: A125809

Credentials and/or board

certification: No

Accepting New Members: Yes

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 229

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

OCEANSIDE

92056

Doemeny, John MD

3601 Vista Way Ste 101

Oceanside, CA 92056

(760) 631-7505

Provider ID: 269751

License: G50925

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Franke, Mark MD

3601 Vista Way Ste 101

Oceanside, CA 92056

(760) 631-7505

Provider ID: 269636

License: A118792

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Moffit, Brian MD

3601 Vista Way Ste 101 Bldg A

Oceanside, CA 92056

(760) 631-7505

Provider ID: 269529

License: G51551

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Tena, Rowena MD

3601 Vista Way Ste 101

Oceanside, CA 92056

(760) 631-7505

Provider ID: 269823

License: A69607

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

POWAY

92064

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 230

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Doemeny, John MD should call the provider’s Provider ID: 245627

12620 Monte Vista Rd Ste A office to discuss their License: G72997

Poway, CA 92064 accessibility needs when there Credentials and/or board

(858) 487-9729 is limited access or when certification: No

Provider ID: 269749 accessibility indicators are not Accepting New Members: Yes

License: G50925 present. Hours: M-SA 9AM-5PM

Credentials and/or board PTA: No

certification: No Cultural Competency: NR

Accepting New Members: Yes Moffit, Brian MD Accessibility: B; Members

Hours: M-SA 9AM-5PM 12620 Monte Vista Rd Ste A should call the provider’s

PTA: No Poway, CA 92064 office to discuss their

Cultural Competency: NR (858) 487-9729 accessibility needs when there

Accessibility: B; Members Provider ID: 269528 is limited access or when

should call the provider’s License: G51551 accessibility indicators are not

office to discuss their Credentials and/or board present.

accessibility needs when there certification: No

is limited access or when Accepting New Members: Yes

accessibility indicators are not Hours: M-SA 9AM-5PM Tena, Rowena MD

present. PTA: No 12620 Monte Vista Rd Ste A

Other Language: Spanish Poway, CA 92064

Cultural Competency: NR (858) 487-9729

Franke, Mark MD Accessibility: B; Members Provider ID: 269825

12620 Monte Vista Rd Ste A should call the provider’s License: A69607

Poway, CA 92064 office to discuss their Credentials and/or board

(858) 487-9729 accessibility needs when there certification: No

Provider ID: 269634 is limited access or when Accepting New Members: Yes

License: A118792 accessibility indicators are not Hours: M-SA 9AM-5PM

Credentials and/or board present. PTA: No

certification: No Other Language: Spanish

Accepting New Members: Yes Cultural Competency: NR

Hours: M-SA 9AM-5PM Schwartzberg, Ross MD Accessibility: B; Members

PTA: No 12620 Monte Vista Rd Ste A should call the provider’s

Cultural Competency: NR Poway, CA 92064 office to discuss their

Accessibility: B; Members (858) 487-9729 accessibility needs when there

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 231

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92102

Rattner, Zachary MD

995 Gateway Center Way Ste

207

San Diego, CA 92102

(619) 263-9729

Provider ID: 269895

License: G86843

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92103

Allen, Derrick MD

150 W Washington St

San Diego, CA 92103

(619) 295-9729

Provider ID: 269614

License: A69840

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Allen, Derrick MD

550 Washington St Ste 200

San Diego, CA 92103

(619) 260-7225

Provider ID: 269617

License: A69840

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Chou, Eric MD

150 W Washington St

San Diego, CA 92103

(858) 658-6500

Provider ID: 243395

License: A96095

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Chou, Eric MD

4077 5th Ave

San Diego, CA 92103

(619) 819-6501

Provider ID: 243396

License: A96095

Credentials and/or board

certification: No

Accepting New Members: Yes

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 232

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Hours: M-SA 9AM-5PM 150 W Washington St office to discuss their

PTA: No San Diego, CA 92103 accessibility needs when there

Cultural Competency: NR (858) 658-6500 is limited access or when

Accessibility: B; Members Provider ID: 269746 accessibility indicators are not

should call the provider’s License: G50925 present.

office to discuss their Credentials and/or board

accessibility needs when there certification: No

is limited access or when Accepting New Members: Yes Doemeny, John MD

accessibility indicators are not Hours: M-SA 9AM-5PM 550 Washington St Ste 200

present. PTA: No San Diego, CA 92103

Cultural Competency: NR (619) 260-7225

Accessibility: B; Members Provider ID: 269757

Cooper, James MD should call the provider’s License: G50925

4077 5th Ave office to discuss their Credentials and/or board

San Diego, CA 92103 accessibility needs when there certification: No

(619) 294-8111 is limited access or when Accepting New Members: Yes

Provider ID: 242475 accessibility indicators are not Hours: M-SA 9AM-5PM

License: A62473 present. PTA: No

Credentials and/or board Cultural Competency: NR

certification: No Accessibility: B; Members

Accepting New Members: Yes Doemeny, John MD should call the provider’s

Hours: M-SA 9AM-5PM 4077 5th Ave office to discuss their

PTA: No San Diego, CA 92103 accessibility needs when there

Cultural Competency: NR (619) 294-8111 is limited access or when

Accessibility: B; Members Provider ID: 269756 accessibility indicators are not

should call the provider’s License: G50925 present.

office to discuss their Credentials and/or board

accessibility needs when there certification: No

is limited access or when Accepting New Members: Yes Franke, Mark MD

accessibility indicators are not Hours: M-SA 9AM-5PM 150 W Washington St

present. PTA: No San Diego, CA 92103

Cultural Competency: NR (858) 658-6500

Accessibility: B; Members Provider ID: 269640

Doemeny, John MD should call the provider’s License: A118792

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 233

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Credentials and/or board Other Language: Spanish

certification: No Cultural Competency: NR

Accepting New Members: Yes Franke, Mark MD Accessibility: B; Members

Hours: M-SA 9AM-5PM 550 Washington St Ste 200 should call the provider’s

PTA: No San Diego, CA 92103 office to discuss their

Cultural Competency: NR (619) 260-7225 accessibility needs when there

Accessibility: B; Members Provider ID: 269642 is limited access or when

should call the provider’s License: A118792 accessibility indicators are not

office to discuss their Credentials and/or board present.

accessibility needs when there certification: No

is limited access or when Accepting New Members: Yes

accessibility indicators are not Hours: M-SA 9AM-5PM Moffit, Brian MD

present. PTA: No 550 Washington St Ste 200

Cultural Competency: NR San Diego, CA 92103

Accessibility: B; Members (619) 260-7225

Franke, Mark MD should call the provider’s Provider ID: 269534

4077 5th Ave office to discuss their License: G51551

San Diego, CA 92103 accessibility needs when there Credentials and/or board

(619) 294-8111 is limited access or when certification: No

Provider ID: 269641 accessibility indicators are not Accepting New Members: Yes

License: A118792 present. Hours: M-SA 9AM-5PM

Credentials and/or board PTA: No

certification: No Other Language: Spanish

Accepting New Members: Yes Moffit, Brian MD Cultural Competency: NR

Hours: M-SA 9AM-5PM 150 W Washington St Accessibility: B; Members

PTA: No San Diego, CA 92103 should call the provider’s

Cultural Competency: NR (858) 658-6500 office to discuss their

Accessibility: B; Members Provider ID: 269525 accessibility needs when there

should call the provider’s License: G51551 is limited access or when

office to discuss their Credentials and/or board accessibility indicators are not

accessibility needs when there certification: No present.

is limited access or when Accepting New Members: Yes

accessibility indicators are not Hours: M-SA 9AM-5PM

present. PTA: No Moffit, Brian MD

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 234

Page 257: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

4077 5th Ave should call the provider’s License: G72997

San Diego, CA 92103 office to discuss their Credentials and/or board

(619) 294-8111 accessibility needs when there certification: No

Provider ID: 269536 is limited access or when Accepting New Members: Yes

License: G51551 accessibility indicators are not Hours: M-SA 9AM-5PM

Credentials and/or board present. PTA: No

certification: No Cultural Competency: NR

Accepting New Members: Yes Accessibility: B; Members

Hours: M-SA 9AM-5PM Schwartzberg, Ross MD should call the provider’s

PTA: No 150 W Washington St office to discuss their

Other Language: Spanish San Diego, CA 92103 accessibility needs when there

Cultural Competency: NR (619) 295-9729 is limited access or when

Accessibility: B; Members Provider ID: 245624 accessibility indicators are not

should call the provider’s License: G72997 present.

office to discuss their Credentials and/or board

accessibility needs when there certification: No

is limited access or when Accepting New Members: Yes Schwartzberg, Ross MD

accessibility indicators are not Hours: M-SA 9AM-5PM 550 Washington St Ste 200

present. PTA: No San Diego, CA 92103

Cultural Competency: NR (619) 260-7225

Accessibility: B; Members Provider ID: 245632

Sabir, Sharjeel MD should call the provider’s License: G72997

4077 5th Ave office to discuss their Credentials and/or board

San Diego, CA 92103 accessibility needs when there certification: No

(619) 862-6500 is limited access or when Accepting New Members: Yes

Provider ID: 269857 accessibility indicators are not Hours: M-SA 9AM-5PM

License: C158962 present. PTA: No

Credentials and/or board Cultural Competency: NR

certification: No Accessibility: B; Members

Accepting New Members: Yes Schwartzberg, Ross MD should call the provider’s

Hours: M-SA 9AM-5PM 4077 5th Ave office to discuss their

PTA: No San Diego, CA 92103 accessibility needs when there

Cultural Competency: NR (619) 294-8111 is limited access or when

Accessibility: B; Members Provider ID: 245626 accessibility indicators are not

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 235

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

present. Hours: M-SA 9AM-5PM 92113 PTA: No

Other Language: Spanish Doemeny, John MD

Tena, Rowena MD Cultural Competency: NR 1809 National Ave Ste 2104

150 W Washington St Accessibility: B; Members San Diego, CA 92113

San Diego, CA 92103 should call the provider’s (858) 658-6500

(858) 658-6500 office to discuss their Provider ID: 269753

Provider ID: 269822 accessibility needs when there License: G50925

License: A69607 is limited access or when Credentials and/or board

Credentials and/or board accessibility indicators are not certification: No

certification: No present. Accepting New Members: Yes

Accepting New Members: Yes Hours: M-SA 9AM-5PM

Hours: M-SA 9AM-5PM PTA: No

PTA: No Tena, Rowena MD Cultural Competency: NR

Other Language: Spanish 550 Washington St Ste 200 Accessibility: B; Members

Cultural Competency: NR San Diego, CA 92103 should call the provider’s

Accessibility: B; Members (619) 260-7225 office to discuss their

should call the provider’s Provider ID: 269832 accessibility needs when there

office to discuss their License: A69607 is limited access or when

accessibility needs when there Credentials and/or board accessibility indicators are not

is limited access or when certification: No present.

accessibility indicators are not Accepting New Members: Yes

present. Hours: M-SA 9AM-5PM

PTA: No Franke, Mark MD

Other Language: Spanish 1809 National Ave Ste 2104

Tena, Rowena MD Cultural Competency: NR San Diego, CA 92113

4077 5th Ave Accessibility: B; Members (858) 658-6500

San Diego, CA 92103 should call the provider’s Provider ID: 269638

(619) 294-8111 office to discuss their License: A118792

Provider ID: 269830 accessibility needs when there Credentials and/or board

License: A69607 is limited access or when certification: No

Credentials and/or board accessibility indicators are not Accepting New Members: Yes

certification: No present. Hours: M-SA 9AM-5PM

Accepting New Members: Yes PTA: No

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 236

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Cultural Competency: NR San Diego, CA 92113 should call the provider’s

Accessibility: B; Members (858) 658-6500 office to discuss their

should call the provider’s Provider ID: 265583 accessibility needs when there

office to discuss their License: A69607 is limited access or when

accessibility needs when there Credentials and/or board accessibility indicators are not

is limited access or when certification: No present.

accessibility indicators are not Accepting New Members: Yes

present. Hours: M-SA 9AM-5PM

PTA: No Franke, Mark MD

Other Language: Spanish 6386 Alvarado Ct Ste 121

Moffit, Brian MD Cultural Competency: NR San Diego, CA 92120

1809 National Ave Ste 2104 Accessibility: B; Members (619) 229-2299

San Diego, CA 92113 should call the provider’s Provider ID: 269637

(858) 658-6500 office to discuss their License: A118792

Provider ID: 269531 accessibility needs when there Credentials and/or board

License: G51551 is limited access or when certification: No

Credentials and/or board accessibility indicators are not Accepting New Members: Yes

certification: No present. Hours: M-SA 9AM-5PM

Accepting New Members: Yes PTA: No

Hours: M-SA 9AM-5PM 92120 Cultural Competency: NR

PTA: No Accessibility: B; Members

Other Language: Spanish Doemeny, John MD should call the provider’s

Cultural Competency: NR 6386 Alvarado Ct Ste 121 office to discuss their

Accessibility: B; Members San Diego, CA 92120 accessibility needs when there

should call the provider’s (619) 229-2299 is limited access or when

office to discuss their Provider ID: 269752 accessibility indicators are not

accessibility needs when there License: G50925 present.

is limited access or when Credentials and/or board

accessibility indicators are not certification: No

present. Accepting New Members: Yes Lubisich, John MD

Hours: M-SA 9AM-5PM 6655 Alvarado Rd

PTA: No San Diego, CA 92120

Tena, Rowena MD Cultural Competency: NR (866) 558-4320

1809 National Ave Ste 2104 Accessibility: B; Members Provider ID: 244953

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 237

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

License: G77575 accessibility indicators are not Hours: M-SA 9AM-5PM

Credentials and/or board present. PTA: No

certification: No Other Language: Spanish

Accepting New Members: Yes Cultural Competency: NR

Hours: M-SA 9AM-5PM Schwartzberg, Ross MD Accessibility: B; Members

PTA: No 6386 Alvarado Ct Ste 121 should call the provider’s

Cultural Competency: NR San Diego, CA 92120 office to discuss their

Accessibility: B; Members (619) 229-2299 accessibility needs when there

should call the provider’s Provider ID: 245631 is limited access or when

office to discuss their License: G72997 accessibility indicators are not

accessibility needs when there Credentials and/or board present.

is limited access or when certification: No

accessibility indicators are not Accepting New Members: Yes 92123 present. Hours: M-SA 9AM-5PM

PTA: No Allen, Derrick MD

Cultural Competency: NR 3939 Ruffin Rd Ste 102

Moffit, Brian MD Accessibility: B; Members San Diego, CA 92123

6386 Alvarado Ct Ste 121 should call the provider’s (858) 658-6500

San Diego, CA 92120 office to discuss their Provider ID: 269615

(619) 229-2299 accessibility needs when there License: A69840

Provider ID: 269530 is limited access or when Credentials and/or board

License: G51551 accessibility indicators are not certification: No

Credentials and/or board present. Accepting New Members: Yes

certification: No Hours: M-SA 9AM-5PM

Accepting New Members: Yes PTA: No

Hours: M-SA 9AM-5PM Tena, Rowena MD Cultural Competency: NR

PTA: No 6386 Alvarado Ct Ste 121 Accessibility: B; Members

Other Language: Spanish San Diego, CA 92120 should call the provider’s

Cultural Competency: NR (619) 229-2299 office to discuss their

Accessibility: B; Members Provider ID: 269828 accessibility needs when there

should call the provider’s License: A69607 is limited access or when

office to discuss their Credentials and/or board accessibility indicators are not

accessibility needs when there certification: No present.

is limited access or when Accepting New Members: Yes

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 238

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Accessibility: B; Members Provider ID: 244954

Chou, Eric MD should call the provider’s License: G77575

3939 Ruffin Rd Ste 102 office to discuss their Credentials and/or board

San Diego, CA 92123 accessibility needs when there certification: No

(858) 658-6500 is limited access or when Accepting New Members: Yes

Provider ID: 243397 accessibility indicators are not Hours: M-SA 9AM-5PM

License: A96095 present. PTA: No

Credentials and/or board Cultural Competency: NR

certification: No Accessibility: B; Members

Accepting New Members: Yes Franke, Mark MD should call the provider’s

Hours: M-SA 9AM-5PM 3939 Ruffin Rd Ste 102 office to discuss their

PTA: No San Diego, CA 92123 accessibility needs when there

Cultural Competency: NR (858) 658-6500 is limited access or when

Accessibility: B; Members Provider ID: 269632 accessibility indicators are not

should call the provider’s License: A118792 present.

office to discuss their Credentials and/or board

accessibility needs when there certification: No

is limited access or when Accepting New Members: Yes Moffit, Brian MD

accessibility indicators are not Hours: M-SA 9AM-5PM 3939 Ruffin Rd Ste 102

present. PTA: No San Diego, CA 92123

Cultural Competency: NR (858) 658-6500

Accessibility: B; Members Provider ID: 269526

Doemeny, John MD should call the provider’s License: G51551

3939 Ruffin Rd Ste 102 office to discuss their Credentials and/or board

San Diego, CA 92123 accessibility needs when there certification: No

(858) 658-6500 is limited access or when Accepting New Members: Yes

Provider ID: 269747 accessibility indicators are not Hours: M-SA 9AM-5PM

License: G50925 present. PTA: No

Credentials and/or board Other Language: Spanish

certification: No Cultural Competency: NR

Accepting New Members: Yes Lubisich, John MD Accessibility: B; Members

Hours: M-SA 9AM-5PM 3939 Ruffin Rd Ste 102 should call the provider’s

PTA: No San Diego, CA 92123 office to discuss their

Cultural Competency: NR (858) 658-6500 accessibility needs when there

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 239

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

is limited access or when

accessibility indicators are not

present.

Schwartzberg, Ross MD

3939 Ruffin Rd Ste 102

San Diego, CA 92123

(858) 658-6500

Provider ID: 245625

License: G72997

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Tena, Rowena MD

3939 Ruffin Rd Ste 102

San Diego, CA 92123

(858) 658-6500

Provider ID: 269827

License: A69607

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92127

Straka, Christopher MD

16918 Dove Canyon Rd Ste

103

San Diego, CA 92127

(858) 649-5100

Provider ID: 276875

License: A145989

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SANTEE

92071

Jacobsen, James MD

9640 Mission Gorge Rd Ste H

Santee, CA 92071

(619) 460-2770

Provider ID: 243976

License: A87878

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Moore, Brian MD

9640 Mission Gorge Rd Ste H

Santee, CA 92071

(619) 460-2770

Provider ID: 243961

License: G68336

Credentials and/or board

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 240

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certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Venkatesh, Vijay MD

9640 Mission Gorge Rd Ste H

Santee, CA 92071

(619) 460-2770

Provider ID: 269661

License: A94476

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

VISTA

92084

Allen, Derrick MD

1000 Vale Terrace Dr

Vista, CA 92084

(858) 888-4444

Provider ID: 269616

License: A69840

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Doemeny, John MD

1000 Vale Terrace Dr

Vista, CA 92084

(858) 888-4444

Provider ID: 269754

License: G50925

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Moffit, Brian MD

1000 Vale Terrace Dr

Vista, CA 92084

(858) 888-4444

Provider ID: 269532

License: G51551

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 241

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Registered Dietitian /

Nutritionist

ESCONDIDO

92025

Baker, Janice RD

488 E Valley Pkwy Ste 211

Escondido, CA 92025

(760) 294-2266

Provider ID: 269136

License: 647205

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

POWAY

92064

Baker, Janice RD

15611 Pomerado Rd Ste 400

Poway, CA 92064

(858) 675-3150

Provider ID: 269135

License: 647205

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Registered Physical Therapist

CARLSBAD

92008

Alaby, Amy PT

3070 Madison St

Carlsbad, CA 92008

(760) 591-7750

Provider ID: 269217

License: PT42087

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Ambrose, Christopher PT

3070 Madison St

Carlsbad, CA 92008

(760) 434-6100

Provider ID: 248010

License: PT26311

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Baker, Lisa PT

3070 Madison St

Carlsbad, CA 92008

(760) 591-7750

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 242

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Provider ID: 269094 accessibility indicators are not Hours: M-SA 9AM-5PM

License: PT22824 present. PTA: No

Credentials and/or board Cultural Competency: NR

certification: No Accessibility: B; Members

Accepting New Members: Yes Boutelle, David RPT should call the provider’s

Hours: M-SA 9AM-5PM 3070 Madison St office to discuss their

PTA: No Carlsbad, CA 92008 accessibility needs when there

Cultural Competency: NR (760) 434-6100 is limited access or when

Accessibility: B; Members Provider ID: 248307 accessibility indicators are not

should call the provider’s License: PT12422 present.

office to discuss their Credentials and/or board

accessibility needs when there certification: No

is limited access or when Accepting New Members: Yes Oliveros, Yunnuen PT

accessibility indicators are not Hours: M-SA 9AM-5PM 3070 Madison St

present. PTA: Yes Carlsbad, CA 92008

Cultural Competency: NR (760) 434-6100

Accessibility: B; Members Provider ID: 277464

Boutelle, Barbara RPT should call the provider’s License: PT294386

3070 Madison St office to discuss their Credentials and/or board

Carlsbad, CA 92008 accessibility needs when there certification: No

(760) 434-6100 is limited access or when Accepting New Members: Yes

Provider ID: 246318 accessibility indicators are not Hours: M-SA 9AM-5PM

License: PT12716 present. PTA: No

Credentials and/or board Cultural Competency: NR

certification: No Accessibility: B; Members

Accepting New Members: Yes Mcgee, Jacqueline PT should call the provider’s

Hours: M-SA 9AM-5PM 3070 Madison St office to discuss their

PTA: Yes Carlsbad, CA 92008 accessibility needs when there

Cultural Competency: NR (760) 434-6100 is limited access or when

Accessibility: B; Members Provider ID: 252472 accessibility indicators are not

should call the provider’s License: PT294790 present.

office to discuss their Credentials and/or board

accessibility needs when there certification: No CHULA VISTA is limited access or when Accepting New Members: Yes

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 243

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Cultural Competency: NR (619) 585-710491910 Accessibility: B; Members Provider ID: 268947

Bush, Nathanael PT should call the provider’s License: PT295601

1020 Tierra Del Rey Ste A1 office to discuss their Credentials and/or board

Chula Vista, CA 91910 accessibility needs when there certification: No

(619) 585-7104 is limited access or when Accepting New Members: Yes

Provider ID: 268896 accessibility indicators are not Hours: M-SA 9AM-5PM

License: PT295464 present. PTA: No

Credentials and/or board Cultural Competency: NR

certification: No Accessibility: B; Members

Accepting New Members: Yes Crittenden, Jennifer PT should call the provider’s

Hours: M-SA 9AM-5PM 480 Fourth Ave Ste 509 office to discuss their

PTA: No Chula Vista, CA 91910 accessibility needs when there

Cultural Competency: NR (619) 651-9760 is limited access or when

Accessibility: B; Members Provider ID: 268695 accessibility indicators are not

should call the provider’s License: PT39118 present.

office to discuss their Credentials and/or board

accessibility needs when there certification: No

is limited access or when Accepting New Members: Yes Dones, Gina RPT

accessibility indicators are not Hours: M-SA 9AM-5PM 1020 Tierra Del Rey Ste A-1

present. PTA: No Chula Vista, CA 91910

Cultural Competency: NR (619) 585-7104

Accessibility: B; Members Provider ID: 268856

Chang, Robert PT should call the provider’s License: PT39455

1020 Tierra Del Rey Ste A1 office to discuss their Credentials and/or board

Chula Vista, CA 91910 accessibility needs when there certification: No

(619) 585-7104 is limited access or when Accepting New Members: Yes

Provider ID: 268910 accessibility indicators are not Hours: M-SA 9AM-5PM

License: PT291836 present. PTA: No

Credentials and/or board Cultural Competency: NR

certification: No Accessibility: B; Members

Accepting New Members: Yes Dicenso, Philip PT should call the provider’s

Hours: M-SA 9AM-5PM 1020 Tierra Del Rey Ste A1 office to discuss their

PTA: No Chula Vista, CA 91910 accessibility needs when there

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 244

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

is limited access or when

accessibility indicators are not

present.

Hastings, Natasha PT

1020 Tierra Del Rey Ste A1

Chula Vista, CA 91910

(619) 585-7104

Provider ID: 268895

License: PT291371

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Introcaso, Brianna PT

1020 Tierra Del Rey Ste A1

Chula Vista, CA 91910

(619) 585-7104

Provider ID: 268948

License: PT293801

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Langworthy, Matthew PT

1020 Tierra Del Rey Ste A1

Chula Vista, CA 91910

(619) 585-7104

Provider ID: 268866

License: PT294466

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Morigeau, Samantha PT

1020 Tierra Del Rey Ste A1

Chula Vista, CA 91910

(619) 585-7104

Provider ID: 269051

License: PT42287

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Marsolini, Kayleigh PT

1020 Tierra Del Rey Ste A-1

Chula Vista, CA 91910

(619) 585-7104

Provider ID: 268949

License: PT294481

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 245

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Accessibility: B; Members Provider ID: 268902 is limited access or when

should call the provider’s License: PT295612 accessibility indicators are not

office to discuss their Credentials and/or board present.

accessibility needs when there certification: No

is limited access or when Accepting New Members: Yes

accessibility indicators are not Hours: M-SA 9AM-5PM Santamaria, Jennifer PT

present. PTA: No 1392 E Palomar St Ste 503

Cultural Competency: NR Chula Vista, CA 91913

Accessibility: B; Members (619) 482-3000

Oliveros, Yunnuen PT should call the provider’s Provider ID: 243544

1020 Tierra Del Rey Ste A1 office to discuss their License: PT296313

Chula Vista, CA 91910 accessibility needs when there Credentials and/or board

(619) 585-7104 is limited access or when certification: No

Provider ID: 268905 accessibility indicators are not Accepting New Members: Yes

License: PT294386 present. Hours: M-SA 9AM-5PM

Credentials and/or board PTA: No

certification: No 91913 Other Language: Spanish

Accepting New Members: Yes Cultural Competency: NR

Hours: M-SA 9AM-5PM Dagostino, Jacqueline PT Accessibility: B; Members

PTA: No 1392 E Palomar St Ste 503 should call the provider’s

Cultural Competency: NR Chula Vista, CA 91913 office to discuss their

Accessibility: B; Members (619) 482-3000 accessibility needs when there

should call the provider’s Provider ID: 243632 is limited access or when

office to discuss their License: PT295756 accessibility indicators are not

accessibility needs when there Credentials and/or board present.

is limited access or when certification: No

accessibility indicators are not Accepting New Members: Yes

present. Hours: M-SA 9AM-5PM Sheffield, Tiffany PT

PTA: No 1392 E Palomar St Ste 503

Cultural Competency: NR Chula Vista, CA 91913

Rydinski, Miles PT Accessibility: B; Members (619) 482-3000

1020 Tierra Del Rey Ste A1 should call the provider’s Provider ID: 255402

Chula Vista, CA 91910 office to discuss their License: PT296953

(619) 585-7104 accessibility needs when there Credentials and/or board

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 246

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certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Sparks, Todd PT

1392 E Palomar St Ste 503

Chula Vista, CA 91913

(619) 482-3000

Provider ID: 129142

License: PT30298

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

EL CAJON

92021

Miller, Richard PT

1625 E Main St Ste 100

El Cajon, CA 92021

(619) 376-1082

Provider ID: 269763

License: PT22474

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Santiago, Alicia PT

1625 E Main St Ste 104

El Cajon, CA 92021

(619) 873-2160

Provider ID: 269688

License: PT292418

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ENCINITAS

92024

Simmons, Jesse PT

201 S El Camino Real Ste A

Encinitas, CA 92024

(760) 274-1671

Provider ID: 269336

License: PT40517

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 247

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Simmons, Thomas RPT

201 S El Camino Real Ste A

Encinitas, CA 92024

(760) 274-1671

Provider ID: 269272

License: PT11587

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ESCONDIDO

92025

Cullison, Kaleb PT

255 N Elm St Ste 202

Escondido, CA 92025

(760) 504-0223

Provider ID: 269216

License: PT38863

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Tully, Michael PT

255 N Elm St Ste 202

Escondido, CA 92025

(760) 504-0223

Provider ID: 269232

License: PT293675

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92027

Mcgee, Jacqueline PT

1815 E Valley Pkwy Ste 5

Escondido, CA 92027

(760) 434-6100

Provider ID: 252473

License: PT294790

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Meister, Sarah PT

1815 E Valley Pkwy Ste 5

Escondido, CA 92027

(760) 434-6100

Provider ID: 269213

License: PT291898

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 248

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Parker, Cory PT

1815 E Valley Pkwy Ste 5

Escondido, CA 92027

(760) 434-6100

Provider ID: 269227

License: PT296440

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

FALLBROOK

92028

Dolojan, Raphael PT

521 E Elder St Ste 106

Fallbrook, CA 92028

(760) 723-8337

Provider ID: 269186

License: PT42764

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Kaplan, Christopher PT

521 E Elder St Ste 106

Fallbrook, CA 92028

(760) 723-8337

Provider ID: 269187

License: PT292488

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Tully, Michael PT

521 E Elder St Ste 106

Fallbrook, CA 92028

(760) 723-8337

Provider ID: 269233

License: PT293675

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

IMPERIAL BEACH

91932

Sheffield, Tiffany PT

600 Palm Ave Ste 126

Imperial Beach, CA 91932

(619) 482-3000

Provider ID: 255403

License: PT296953

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 249

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Credentials and/or board accessibility indicators are not certification: No

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

NATIONAL CITY

91950

Diep, Huy PT

1626 Sweetwater Rd Ste A & B

National City, CA 91950

(619) 474-5916

Provider ID: 269130

License: PT294143

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

present.

Foley, Hanna PT

1626 Sweetwater Rd Ste A&b

National City, CA 91950

(619) 474-5916

Provider ID: 269163

License: PT291095

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

OCEANSIDE

92054

Lee, Michael PT

2335 Vista Way

Oceanside, CA 92054

(855) 344-5870

Provider ID: 269372

License: PT43323

Credentials and/or board

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Rheaume, Alexander PT

2335 Vista Way

Oceanside, CA 92054

(760) 547-2666

Provider ID: 269461

License: PT39516

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 250

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Hours: M-SA 9AM-5PM92056 92065

Andrew, Meagan PT

3142 Vista Way Ste 101

Oceanside, CA 92056

(951) 696-9353

Provider ID: 269373

License: PT291748

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

POWAY

92064

Blackburn, Gary PT

15525 Pomerado Rd Ste D4

Poway, CA 92064

(858) 674-1600

Provider ID: 269448

License: PT28897

Credentials and/or board

certification: No

Accepting New Members: Yes

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Chan, Oriana PT

15525 Pomerado Rd Ste D4

Poway, CA 92064

(858) 674-1600

Provider ID: 129858

License: PT293406

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

RAMONA

Pfeifer, Janaya PT

850 Main St Ste 105

Ramona, CA 92065

(760) 789-1424

Provider ID: 269584

License: PT292928

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92101

Delasantos, Cameron PT

295 G St

San Diego, CA 92101

(619) 238-4318

Provider ID: 269849

License: PT293413

Credentials and/or board

certification: No

Accepting New Members: Yes

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 251

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Hours: M-SA 9AM-5PM Hours: M-SA 9AM-5PM

PTA: No Shah, Zalak PT PTA: No

Cultural Competency: NR 295 G St Cultural Competency: NR

Accessibility: B; Members San Diego, CA 92101 Accessibility: B; Members

should call the provider’s (619) 238-4318 should call the provider’s

office to discuss their Provider ID: 269676 office to discuss their

accessibility needs when there License: PT296627 accessibility needs when there

is limited access or when Credentials and/or board is limited access or when

accessibility indicators are not certification: No accessibility indicators are not

present. Accepting New Members: Yes present.

Hours: M-SA 9AM-5PM

PTA: No

Lloyd, Christopher PT Other Language: Gujarati, Heim, Jessica PT

295 G St Hindi 3760 Convoy St Ste 100

San Diego, CA 92101 Cultural Competency: NR San Diego, CA 92111

(888) 208-8526 Accessibility: B; Members (858) 573-9368

Provider ID: 271014 should call the provider’s Provider ID: 269760

License: PT43591 office to discuss their License: PT294241

Credentials and/or board accessibility needs when there Credentials and/or board

certification: No is limited access or when certification: No

Accepting New Members: Yes accessibility indicators are not Accepting New Members: Yes

Hours: M-SA 9AM-5PM present. Hours: M-SA 9AM-5PM

PTA: No PTA: No

Other Language: Arabic, 92111 Cultural Competency: NR

Portuguese, Spanish Accessibility: B; Members

Cultural Competency: NR Becherer, Kelley PT should call the provider’s

Accessibility: B; Members 3760 Convoy St Ste 101 office to discuss their

should call the provider’s San Diego, CA 92111 accessibility needs when there

office to discuss their (855) 543-0333 is limited access or when

accessibility needs when there Provider ID: 270969 accessibility indicators are not

is limited access or when License: PT43240 present.

accessibility indicators are not Credentials and/or board

present. certification: No

Accepting New Members: Yes Pogasic, Seth PT

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 252

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3760 Convoy St Ste 101 office to discuss their License: PT9919

San Diego, CA 92111 accessibility needs when there Credentials and/or board

(858) 537-9368 is limited access or when certification: No

Provider ID: 269675 accessibility indicators are not Accepting New Members: Yes

License: PT294961 present. Hours: M-SA 9AM-5PM

Credentials and/or board PTA: No

certification: No Cultural Competency: NR

Accepting New Members: Yes Zafuta, Alyssa PT Accessibility: B; Members

Hours: M-SA 9AM-5PM 3760 Convoy St Ste 100 should call the provider’s

PTA: No San Diego, CA 92111 office to discuss their

Cultural Competency: NR (858) 573-9368 accessibility needs when there

Accessibility: B; Members Provider ID: 269726 is limited access or when

should call the provider’s License: PT292370 accessibility indicators are not

office to discuss their Credentials and/or board present.

accessibility needs when there certification: No

is limited access or when Accepting New Members: Yes 92131 accessibility indicators are not Hours: M-SA 9AM-5PM

present. PTA: No Jung, Calvin PT

Cultural Competency: NR 9909 Mira Mesa Blvd Ste 120

Accessibility: B; Members San Diego, CA 92131

Strem, Brendan PT should call the provider’s (858) 693-0436

3760 Convoy St Ste 100 office to discuss their Provider ID: 271605

San Diego, CA 92111 accessibility needs when there License: PT42181

(858) 573-9368 is limited access or when Credentials and/or board

Provider ID: 271424 accessibility indicators are not certification: No

License: PT38107 present. Accepting New Members: Yes

Credentials and/or board Hours: M-SA 9AM-5PM

certification: No 92121 PTA: No

Accepting New Members: Yes Other Language: Spanish

Hours: M-SA 9AM-5PM Harrah, William RPT Cultural Competency: NR

PTA: No 9333 Genesee Ave Ste 350b Accessibility: B; Members

Cultural Competency: NR San Diego, CA 92121 should call the provider’s

Accessibility: B; Members (858) 455-8584 office to discuss their

should call the provider’s Provider ID: 269689 accessibility needs when there

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 253

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

is limited access or when

accessibility indicators are not

present.

Kamph, Alexandra PT

9909 Mira Mesa Blvd Ste 120

San Diego, CA 92131

(619) 448-4860

Provider ID: 271606

License: PT41577

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Thomason, Erica PT

9909 Mira Mesa Blvd

San Diego, CA 92131

(619) 448-4860

Provider ID: 271593

License: PT296321

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92154

Owens, Jadriane PT

585 Saturn Blvd Ste A

San Diego, CA 92154

(619) 591-1190

Provider ID: 269738

License: PT292222

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN MARCOS

92069

Duong, Andrew PT

2115 Montiel Rd Ste 103

San Marcos, CA 92069

(760) 839-2905

Provider ID: 269953

License: PT40674

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Hernandez, Rogelio PT

2115 Montiel Rd Ste 103

San Marcos, CA 92069

(760) 839-2905

Provider ID: 270424

License: PT39405

Credentials and/or board

certification: No

Accepting New Members: Yes

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 254

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Hours: M-SA 9AM-5PM Kurtz, Benjamin PT Accessibility: B; Members

PTA: No 277 Rancheros Dr Ste 150 should call the provider’s

Other Language: Spanish San Marcos, CA 92069 office to discuss their

Cultural Competency: NR (951) 696-9353 accessibility needs when there

Accessibility: B; Members Provider ID: 270332 is limited access or when

should call the provider’s License: PT291545 accessibility indicators are not

office to discuss their Credentials and/or board present.

accessibility needs when there certification: No

is limited access or when Accepting New Members: Yes

accessibility indicators are not Hours: M-SA 9AM-5PM Mallinson, Darren PT

present. PTA: No 2115 Montiel Rd Ste 103

Cultural Competency: NR San Marcos, CA 92069

Accessibility: B; Members (760) 839-2905

Jimenez, Monica PT should call the provider’s Provider ID: 271147

2115 Montiel Rd Ste 103 office to discuss their License: PT28994

San Marcos, CA 92069 accessibility needs when there Credentials and/or board

(760) 839-2905 is limited access or when certification: No

Provider ID: 269773 accessibility indicators are not Accepting New Members: Yes

License: PT33505 present. Hours: M-SA 9AM-5PM

Credentials and/or board PTA: No

certification: No Cultural Competency: NR

Accepting New Members: Yes Lane, Jennifer PT Accessibility: B; Members

Hours: M-SA 9AM-5PM 2115 Montiel Rd # 200 should call the provider’s

PTA: No San Marcos, CA 92069 office to discuss their

Cultural Competency: NR (760) 839-2905 accessibility needs when there

Accessibility: B; Members Provider ID: 270663 is limited access or when

should call the provider’s License: PT37920 accessibility indicators are not

office to discuss their Credentials and/or board present.

accessibility needs when there certification: No

is limited access or when Accepting New Members: Yes

accessibility indicators are not Hours: M-SA 9AM-5PM Shannon, Michael PT

present. PTA: No 2115 Montiel Rd Ste 103

Other Language: Spanish San Marcos, CA 92069

Cultural Competency: NR (760) 839-2905

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 255

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Provider ID: 269581

License: PT27069

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Shao, Paula PT

2115 Montiel Rd Ste 103

San Marcos, CA 92069

(760) 839-2905

Provider ID: 269785

License: PT19297

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Spurrell, Kathryn PT

2115 Montiel Rd Ste 103

San Marcos, CA 92069

(760) 839-2905

Provider ID: 269602

License: PT40706

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Yap, Amanda PT

2115 Montiel Rd Ste 103

San Marcos, CA 92069

(760) 839-2905

Provider ID: 270649

License: PT292801

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Chinese,

Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SANTEE

92071

Boutelle, David RPT

9830 Prospect Ave Ste A

Santee, CA 92071

(619) 448-4860

Provider ID: 248308

License: PT12422

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 256

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

present.

Daher, Nicole PT

9830 Prospect Ave Ste A

Santee, CA 92071

(619) 448-4860

Provider ID: 270343

License: PT42881

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Dansey, Ashley PT

9830 Prospect Ave Ste A

Santee, CA 92071

(619) 448-4860

Provider ID: 270339

License: PT36952

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Grieger, Nancy PT

8790 Cuyamaca St Ste A

Santee, CA 92071

(619) 596-5969

Provider ID: 270118

License: PT40167

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Miller, Laura PT

8790 Cuyamaca St Ste A

Santee, CA 92071

(619) 596-5969

Provider ID: 271143

License: PT26121

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Monroe, Max PT

8790 Cuyamaca St Ste A

Santee, CA 92071

(619) 596-5969

Provider ID: 269925

License: PT294368

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 257

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Rouillard, Norma PT

8790 Cuyamaca St Ste A

Santee, CA 92071

(619) 596-5969

Provider ID: 269600

License: PT29262

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

VISTA

92083

Ambrose, Christopher PT

2067 W Vista Way Ste 185

Vista, CA 92083

(760) 631-5888

Provider ID: 248009

License: PT26311

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Smith, Dennis PT

2067 W Vista Way Ste 185

Vista, CA 92083

(760) 631-5888

Provider ID: 247478

License: PT22171

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Rheumatology

CHULA VISTA

91910

Kotha, Akther MD

374 H St Ste 103

Chula Vista, CA 91910

(619) 205-0120

Provider ID: 53697

License: A45440

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Hindi, Spanish, Telugu, Urdu

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

91911

Chitkara, Puja MD

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 258

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

765 Medical Center Ct Ste 216

Chula Vista, CA 91911

(619) 623-3000

Provider ID: 204158

License: A97619

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Hindi,

Russian, Spanish, Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Chwa, Jeffrey DO

765 Medical Center Ct Ste 216

Chula Vista, CA 91911

(619) 623-3000

Provider ID: 268780

License: 20A14736

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Pazirandeh, Mahmood MD

1310 3rd Ave Ste B3

Chula Vista, CA 91911

(619) 827-0276

Provider ID: 268796

License: C52328

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Farsi,

Russian, Spanish, Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ESCONDIDO

92025

Rao, Soumya MD

488 E Valley Pkwy Ste 211

Escondido, CA 92025

(858) 675-3150

Provider ID: 269101

License: A99911

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Hindi,

Kannada, Russian, Spanish,

Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA MESA

91942

Kotha, Akther MD

8860 Center Dr Ste 400

La Mesa, CA 91942

(619) 229-1995

Provider ID: 29099

License: A45440

Credentials and/or board

certification: No

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 259

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Arabic,

Hindi, Spanish, Telugu, Urdu

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Kotha, Roshan MD

8860 Center Dr Ste 400

La Mesa, CA 91942

(619) 229-1995

Provider ID: 63454

License: A106044

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Hindi,

Spanish, Telugu

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

NATIONAL CITY

91950

Chitkara, Puja MD

502 Euclid Ave Ste 300

National City, CA 91950

(619) 623-3000

Provider ID: 204159

License: A97619

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Hindi,

Russian, Spanish, Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

POWAY

92064

Rao, Soumya MD

15611 Pomerado Rd Ste 400

Poway, CA 92064

(858) 675-3150

Provider ID: 46060

License: A99911

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Hindi,

Kannada, Russian, Spanish,

Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Reddy, Smitha MD

15725 Pomerado Rd Ste 117

Poway, CA 92064

(858) 312-1717

Provider ID: 269402

License: A85072

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 260

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Other Language: Hindi,

Kannada, Telugu

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92108

Pazirandeh, Mahmood MD

3633 Camino Del Rio S Ste 300

San Diego, CA 92108

(619) 287-9730

Provider ID: 209535

License: C52328

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Russian, Spanish, Tagalog

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Surgery Cardiovascular

ESCONDIDO

92029

Lin, Yuan MD

1955 Citracado Pkwy Ste 300

Escondido, CA 92029

(760) 743-0546

Provider ID: 241290

License: A43050

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Cantonese,

Mandarin, Yue Chinese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Surgery Colon Surgery

SAN DIEGO

92103

Isho, Mathew MD

4060 4th Ave Ste 510

San Diego, CA 92103

(619) 686-4011

Provider ID: 245185

License: A93470

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Arabic

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Surgery General Vascular

CHULA VISTA

91911

Salloum, Alexander MD

1111 Broadway Ste 305

Chula Vista, CA 91911

(619) 567-7007

Provider ID: 268764

License: A89300

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 261

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ESCONDIDO

92025

Bulkin, Anatoly MD

625 Citracado Pkwy Ste 203

Escondido, CA 92025

(760) 739-7666

Provider ID: 51838

License: G79826

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Russian,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Chang, Alexander MD

625 Citracado Pkwy Ste 203

Escondido, CA 92025

(760) 739-7666

Provider ID: 75855

License: A123245

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Korean

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Nemceff, Dennis MD

625 Citracado Pkwy Ste 203

Escondido, CA 92025

(760) 739-7666

Provider ID: 246553

License: A123910

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Russian

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92115

Salloum, Alexander MD

6402 El Cajon Blvd Ste 100 &

102

San Diego, CA 92115

(619) 582-4490

Provider ID: 268765

License: A89300

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 262

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Surgery General

CHULA VISTA

91910

Hsu, Andrew MD

480 4th Ave Ste 404

Chula Vista, CA 91910

(619) 425-4559

Provider ID: 53785

License: A108956

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Mandarin,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Hsu, Bradford MD

480 4th Ave Ste 404

Chula Vista, CA 91910

(619) 425-4559

Provider ID: 53792

License: A86179

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Yu, Nicholas MD

480 4th Ave Ste 404

Chula Vista, CA 91910

(619) 425-5184

Provider ID: 100762

License: A136120

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Korean,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ESCONDIDO

92029

Grove, Jay MD

2185 Citracado Pkwy

Escondido, CA 92029

(760) 300-3647

Provider ID: 245226

License: A60426

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 263

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221

SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

LA MESA

91942

Dickinson, Phillip MD

8554 La Mesa Blvd

La Mesa, CA 91942

(619) 464-4469

Provider ID: 269694

License: A86720

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Lin, Hong-der MD

5565 Grossmont Center Dr Ste

La Mesa, CA 91942

(619) 462-8100

Provider ID: 268968

License: C42964

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Chinese,

Japanese, Mandarin, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Lavotshkin, Simon MD

5565 Grossmont Center Dr Ste

221 Bldg 1

La Mesa, CA 91942

(619) 462-8100

Provider ID: 268988

License: A125514

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Chinese,

Hebrew, Korean, Russian,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Orr, Carl MD

5565 Grossmont Center Dr Ste

221

La Mesa, CA 91942

(619) 462-8100

Provider ID: 26549

License: G58899

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Sohn, Helen MD

5565 Grossmont Center Dr Ste

221

La Mesa, CA 91942

(619) 462-8100

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 264

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Provider ID: 268903

License: A87722

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92103

Kurtzhals, Pamela MD

3366 5th Ave

San Diego, CA 92103

(619) 550-1500

Provider ID: 269976

License: A75524

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there Credentials and/or board

is limited access or when certification: Yes

accessibility indicators are not Accepting New Members: Yes

present. Hours: M-SA 9AM-5PM

PTA: No

92123 Cultural Competency: NR

Accessibility: B; Members

Bench, Gary MD should call the provider’s

7910 Frost St Ste 250 office to discuss their

San Diego, CA 92123 accessibility needs when there

(858) 565-0104 is limited access or when

Provider ID: 269682 accessibility indicators are not

License: A35873 present.

Credentials and/or board

certification: No

Accepting New Members: Yes Brown, Kristian MD

Hours: M-SA 9AM-5PM 8010 Frost St Ste 510

PTA: No San Diego, CA 92123

Cultural Competency: NR (858) 637-4800

Accessibility: B; Members Provider ID: 97599

should call the provider’s License: A124291

office to discuss their Credentials and/or board

accessibility needs when there certification: No

is limited access or when Accepting New Members: Yes

accessibility indicators are not Hours: M-SA 9AM-5PM

present. PTA: No

Cultural Competency: NR

Accessibility: B; Members

Bench, Shawn MD should call the provider’s

7910 Frost St Ste 250 office to discuss their

San Diego, CA 92123 accessibility needs when there

(858) 565-0104 is limited access or when

Provider ID: 129060 accessibility indicators are not

License: A108975 present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 265

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Other Language: Spanish, 8010 Frost St Ste 510

Tagalog San Diego, CA 92123

Barnes, Ryan DO Cultural Competency: NR (858) 499-1900

7910 Frost St Ste 250 Accessibility: B; Members Provider ID: 82513

San Diego, CA 92123 should call the provider’s License: A60375

(858) 565-0104 office to discuss their Credentials and/or board

Provider ID: 129062 accessibility needs when there certification: No

License: 20A12870 is limited access or when Accepting New Members: Yes

Credentials and/or board accessibility indicators are not Hours: M-SA 9AM-5PM

certification: No present. PTA: No

Accepting New Members: Yes Other Language: Spanish

Hours: M-SA 9AM-5PM Cultural Competency: NR

PTA: No Hart, Marquis MD Accessibility: B; Members

Cultural Competency: NR 8010 Frost St Ste 510 should call the provider’s

Accessibility: B; Members San Diego, CA 92123 office to discuss their

should call the provider’s (858) 637-4800 accessibility needs when there

office to discuss their Provider ID: 279694 is limited access or when

accessibility needs when there License: A42694 accessibility indicators are not

is limited access or when Credentials and/or board present.

accessibility indicators are not certification: No

present. Accepting New Members: Yes

Hours: M-SA 9AM-5PM Mueller, George MD

PTA: No 7910 Frost St Ste 250

Halldorson, Jeffrey MD Cultural Competency: NR San Diego, CA 92123

8010 Frost St Ste 510 Accessibility: B; Members (858) 565-0104

San Diego, CA 92123 should call the provider’s Provider ID: 54298

(858) 637-4800 office to discuss their License: A41127

Provider ID: 270147 accessibility needs when there Credentials and/or board

License: G86089 is limited access or when certification: Yes

Credentials and/or board accessibility indicators are not Accepting New Members: Yes

certification: No present. Hours: M-SA 9AM-5PM

Accepting New Members: Yes PTA: No

Hours: M-SA 9AM-5PM Other Language: Spanish,

PTA: No Kosoy, Daniel MD Vietnamese

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 266

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Pollack, Larry MD

7910 Frost St Ste 250

San Diego, CA 92123

(858) 565-0104

Provider ID: 54346

License: A41696

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: German,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Woodward, Stephanie MD

7910 Frost St Ste 250

San Diego, CA 92123

(858) 565-0104

Provider ID: 63697

License: A103828

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

VISTA

92081

Fierer, Adam MD

2385 S Melrose Dr

Vista, CA 92081

(760) 300-3647

Provider ID: 86667

License: G69685

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Grove, Jay MD

2385 S Melrose Dr

Vista, CA 92081

(760) 300-3647

Provider ID: 245227

License: A60426

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Hanna, Karen MD

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 267

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

2385 S Melrose Dr

Vista, CA 92081

(760) 300-3647

Provider ID: 246422

License: G88851

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Surgery Hand

ESCONDIDO

92029

Patel, Arush MD

1955 Citracado Pkwy Ste 200

Escondido, CA 92029

(760) 743-4789

Provider ID: 77773

License: A105982

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Surgery Neurological

ENCINITAS

92024

Yoo, Frank MD

477 N El Camino Real Ste D200

Encinitas, CA 92024

(760) 452-3340

Provider ID: 257374

License: G86513

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Korean,

Spanish, Telugu, Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ESCONDIDO

92025

Stern, Mark MD

705 E Ohio Ave

Escondido, CA 92025

(760) 489-9490

Provider ID: 243486

License: G47596

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA JOLLA

92037

Yoo, Frank MD

9850 Genesee Ave Ste 560

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 268

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

La Jolla, CA 92037

(858) 909-9033

Provider ID: 248120

License: G86513

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Korean,

Spanish, Telugu, Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

NATIONAL CITY

91950

Yoo, Frank MD

2345 E 8th St Ste 110

National City, CA 91950

(858) 909-9033

Provider ID: 257372

License: G86513

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Korean,

Spanish, Telugu, Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

OCEANSIDE

92056

Yoo, Frank MD

3998 Vista Way Ste 108

Oceanside, CA 92056

(858) 909-9033

Provider ID: 257373

License: G86513

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Korean,

Spanish, Telugu, Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92123

Soumekh, Massoud Hertzel MD

8008 Frost St Ste 401

San Diego, CA 92123

(858) 560-8544

Provider ID: 54178

License: A37843

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Surgery Orthopedic

CHULA VISTA

91910

Bagheri, Ali MD

480 Fourth Ave Ste 501

Chula Vista, CA 91910

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 269

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(619) 425-9510 should call the provider’s Provider ID: 242939

Provider ID: 117911 office to discuss their License: G75293

License: A123272 accessibility needs when there Credentials and/or board

Credentials and/or board is limited access or when certification: No

certification: No accessibility indicators are not Accepting New Members: Yes

Accepting New Members: Yes present. Hours: M-SA 9AM-5PM

Hours: M-SA 9AM-5PM PTA: No

PTA: No Other Language: Spanish

Other Language: Farsi, Rosenfield, Alan MD Cultural Competency: NR

Spanish 480 4th Ave Ste 501 Accessibility: B; Members

Cultural Competency: NR Chula Vista, CA 91910 should call the provider’s

Accessibility: B; Members (619) 425-9510 office to discuss their

should call the provider’s Provider ID: 242937 accessibility needs when there

office to discuss their License: G75293 is limited access or when

accessibility needs when there Credentials and/or board accessibility indicators are not

is limited access or when certification: Yes present.

accessibility indicators are not Accepting New Members: Yes

present. Hours: M-SA 9AM-5PM

PTA: Yes Tayyab, Neil MD

Other Language: Spanish 480 4th Ave Ste 501

Kimball, Michael MD Cultural Competency: NR Chula Vista, CA 91910

480 4th Ave Ste 501 Accessibility: B; Members (619) 425-9510

Chula Vista, CA 91910 should call the provider’s Provider ID: 268616

(858) 455-6460 office to discuss their License: A94408

Provider ID: 268619 accessibility needs when there Credentials and/or board

License: G76060 is limited access or when certification: No

Credentials and/or board accessibility indicators are not Accepting New Members: Yes

certification: Yes present. Hours: M-SA 9AM-5PM

Accepting New Members: Yes PTA: Yes

Hours: M-SA 9AM-5PM Cultural Competency: NR

PTA: Yes Rosenfield, Alan MD Accessibility: B; Members

Other Language: Spanish 480 Fourth Ave Ste 509 should call the provider’s

Cultural Competency: NR Chula Vista, CA 91910 office to discuss their

Accessibility: B; Members (619) 425-9510 accessibility needs when there

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 270

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is limited access or when

accessibility indicators are not

present.

ESCONDIDO

92025

Kimball, Michael MD

457 N Elm St

Escondido, CA 92025

(858) 455-6460

Provider ID: 122878

License: G76060

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92029

Barba, Daniel MD

1955 Citracado Pkwy Ste 200

Escondido, CA 92029

(760) 743-4789

Provider ID: 77895

License: A119351

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Knutson, Thomas MD

1955 Citracado Pkwy Ste 200

Escondido, CA 92029

(760) 743-4789

Provider ID: 31099

License: G50268

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Owsley, Kevin MD

1955 Citracado Pkwy Ste 200

Escondido, CA 92029

(760) 743-4789

Provider ID: 269326

License: A98739

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Sharp, Lorra MD

1955 Citracado Pkwy Ste 200

Escondido, CA 92029

(760) 743-4789

Provider ID: 243552

License: A117353

Credentials and/or board

certification: No

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 271

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Accepting New Members: Yes accessibility indicators are not certification: No

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA MESA

91942

Allsing, Steven MD

5565 Grossmont Center Dr Ste

112 Bldg 1

La Mesa, CA 91942

(619) 465-0083

Provider ID: 211762

License: G84903

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

present. Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Bagheri, Ali MD Other Language: Spanish

8851 Center Dr Ste 601 Cultural Competency: NR

La Mesa, CA 91942 Accessibility: B; Members

(619) 441-9811 should call the provider’s

Provider ID: 125035 office to discuss their

License: A123272 accessibility needs when there

Credentials and/or board is limited access or when

certification: No accessibility indicators are not

Accepting New Members: Yes present.

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi, Rickards, Enass MD

Spanish 8851 Center Dr Ste 601

Cultural Competency: NR La Mesa, CA 91942

Accessibility: B; Members (858) 455-6460

should call the provider’s Provider ID: 268907

office to discuss their License: G79785

accessibility needs when there Credentials and/or board

is limited access or when certification: No

accessibility indicators are not Accepting New Members: Yes

present. Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Arabic

Kimball, Michael MD Cultural Competency: NR

8851 Center Dr Ste 601 Accessibility: B; Members

La Mesa, CA 91942 should call the provider’s

(858) 455-6460 office to discuss their

Provider ID: 44005 accessibility needs when there

License: G76060 is limited access or when

Credentials and/or board accessibility indicators are not

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 272

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

present.

Rosenfield, Alan MD

8851 Center Dr Ste 601

La Mesa, CA 91942

(858) 455-6460

Provider ID: 242936

License: G75293

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

POWAY

92064

Balikian, Philip MD

15611 Pomerado Rd Ste 400

Poway, CA 92064

(858) 675-3286

Provider ID: 119552

License: C52136

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Armenian,

Italian, Spanish, Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Bried, James MD

15611 Pomerado Rd Ste 525

Poway, CA 92064

(858) 485-0050

Provider ID: 269500

License: G62595

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Cohen, Brad MD

15611 Pomerado Rd Ste 525

Poway, CA 92064

(858) 485-0050

Provider ID: 269449

License: A62550

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Owsley, Kevin MD

15611 Pomerado Rd Ste 525

Poway, CA 92064

(858) 485-0050

Provider ID: 269325

License: A98739

Credentials and/or board

certification: No

Accepting New Members: Yes

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 273

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Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Palanca, Ariel MD

15611 Pomerado Rd Ste 525

Poway, CA 92064

(858) 485-0050

Provider ID: 269861

License: A114257

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92120

Alfieri, Keith MD

6719 Alvarado Rd Ste 200

San Diego, CA 92120

(619) 229-5018

Provider ID: 273888

License: C161523

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Burnikel, David MD

6719 Alvarado Rd Ste 200

San Diego, CA 92120

(619) 229-3932

Provider ID: 205079

License: A138043

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Klatman, Samuel MD

6719 Alvarado Rd Ste 200

San Diego, CA 92120

(619) 229-5018

Provider ID: 275652

License: A166831

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Page, Alexandra MD

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 274

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

6719 Alvarado Rd Ste 200 should call the provider’s Provider ID: 218096

San Diego, CA 92120 office to discuss their License: G14672

(619) 229-3932 accessibility needs when there Credentials and/or board

Provider ID: 109720 is limited access or when certification: Yes

License: G84448 accessibility indicators are not Accepting New Members: Yes

Credentials and/or board present. Hours: M-SA 9AM-5PM

certification: No PTA: Yes

Accepting New Members: Yes Cultural Competency: NR

Hours: M-SA 9AM-5PM Shillito, Matthew MD Accessibility: B; Members

PTA: No 6719 Alvarado Rd Ste 200 should call the provider’s

Cultural Competency: NR San Diego, CA 92120 office to discuss their

Accessibility: B; Members (619) 229-3932 accessibility needs when there

should call the provider’s Provider ID: 247893 is limited access or when

office to discuss their License: A109569 accessibility indicators are not

accessibility needs when there Credentials and/or board present.

is limited access or when certification: No

accessibility indicators are not Accepting New Members: Yes 92121 present. Hours: M-SA 9AM-5PM

PTA: No Bagheri, Ali MD

Other Language: Spanish 9333 Genesee Ave Ste 350a

Sirota, Michael MD Cultural Competency: NR San Diego, CA 92121

6719 Alvarado Rd Ste 200 Accessibility: B; Members (858) 455-6460

San Diego, CA 92120 should call the provider’s Provider ID: 117900

(619) 229-3932 office to discuss their License: A123272

Provider ID: 84579 accessibility needs when there Credentials and/or board

License: A129445 is limited access or when certification: No

Credentials and/or board accessibility indicators are not Accepting New Members: Yes

certification: No present. Hours: M-SA 9AM-5PM

Accepting New Members: Yes PTA: No

Hours: M-SA 9AM-5PM Other Language: Farsi,

PTA: Yes Tasto, James MD Spanish

Other Language: Spanish 6719 Alvarado Rd Ste 200 Cultural Competency: NR

Cultural Competency: NR San Diego, CA 92120 Accessibility: B; Members

Accessibility: B, W; Members (619) 229-3932 should call the provider’s

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 275

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Kimball, Michael MD

9333 Genesee Ave Ste 350

San Diego, CA 92121

(858) 455-6460

Provider ID: 38205

License: G76060

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Rickards, Enass MD

9333 Genesee Ave Ste 350

San Diego, CA 92121

(858) 455-6460

Provider ID: 268909

License: G79785

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Rosenfield, Alan MD

9333 Genesee Ave Ste 350

San Diego, CA 92121

(858) 455-6460

Provider ID: 242938

License: G75293

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Tayyab, Neil MD

9333 Genesee Ave Ste 350a

San Diego, CA 92121

(858) 455-6460

Provider ID: 268617

License: A94408

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Urology

ENCINITAS

92024

Butler, Philip MD

320 Santa Fe Dr Ste 305

Encinitas, CA 92024

(760) 436-4558

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 276

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Provider ID: 269433

License: G47129

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Cohen, Edward MD

320 Santa Fe Dr Ste 305

Encinitas, CA 92024

(760) 436-4558

Provider ID: 269340

License: G56844

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Juma, Saad MD

320 Santa Fe Dr Ste 108

Encinitas, CA 92024

(760) 753-8373

Provider ID: 244006

License: A42398

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Naitoh, John MD

320 Santa Fe Dr Ste 305

Encinitas, CA 92024

(760) 436-4558

Provider ID: 269477

License: G82079

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ESCONDIDO

92029

Cohen, Edward MD

1955 Citracado Pkwy Ste 302

Escondido, CA 92029

(760) 743-5111

Provider ID: 269341

License: G56844

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 277

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

office to discuss their (858) 453-5944 office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Jones, Thomas MD

1955 Citracado Pkwy Ste 302

Escondido, CA 92029

(760) 743-5111

Provider ID: 75512

License: G51735

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA JOLLA

92037

Butler, Philip MD

9850 Genesee Ave Ste 440

La Jolla, CA 92037

Provider ID: 65710

License: G47129

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Cohen, Edward MD

9850 Genesee Ave Ste 440

La Jolla, CA 92037

(858) 453-5944

Provider ID: 65713

License: G56844

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Naitoh, John MD

9850 Genesee Ave Ste 440

La Jolla, CA 92037

(858) 453-5944

Provider ID: 55260

License: G82079

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Nguyen, Hung MD

9850 Genesee Ave Ste 440

La Jolla, CA 92037

(858) 453-5944

Provider ID: 246842

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 278

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

License: A142209

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA MESA

91942

Dato, Paul MD

8851 Center Dr Ste 501

La Mesa, CA 91942

(619) 697-2456

Provider ID: 112527

License: A43540

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Kearse, Wilfred MD

8851 Center Dr Ste 501

La Mesa, CA 91942

(619) 697-2456

Provider ID: 268850

License: G83318

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Siegel, Jordan MD

8851 Center Dr Ste 501

La Mesa, CA 91942

(619) 697-2456

Provider ID: 101015

License: A110507

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Salmasi, Amirali MD

8851 Center Dr Ste 501

La Mesa, CA 91942

(619) 697-2456

Provider ID: 129643

License: A135118

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 279

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

accessibility indicators are not

present.

Tanagho, Youssef MD

8851 Center Dr Ste 501

La Mesa, CA 91942

(619) 697-2456

Provider ID: 124747

License: A125924

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

French

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

POWAY

92064

Dicks, Brian MD

12630 Monte Vista Rd Ste 103

Poway, CA 92064

(858) 451-1772

Provider ID: 270141

License: A100413

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Neustein, Paul MD

15644 Pomerado Rd Ste 206

Poway, CA 92064

(858) 485-0554

Provider ID: 42034

License: G42225

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Hebrew,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Pe, Mark- Rally MD

12630 Monte Vista Rd Ste 103

Poway, CA 92064

(858) 451-1772

Provider ID: 269348

License: A112013

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92103

Dicks, Brian MD

4060 4th Ave Ste 310

San Diego, CA 92103

(619) 297-4707

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 280

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

Provider ID: 57668 is limited access or when certification: Yes

License: A100413

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Holden, Marc MD

4060 4th Ave Ste 310

San Diego, CA 92103

(619) 297-4707

Provider ID: 269620

License: A129770

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

accessibility indicators are not

present.

Pe, Mark- Rally MD

4060 4th Ave Ste 310

San Diego, CA 92103

(619) 297-4707

Provider ID: 55252

License: A112013

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Roberts, James MD

4033 3rd Ave Ste 400

San Diego, CA 92103

(619) 299-0670

Provider ID: 65495

License: G59945

Credentials and/or board

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Salem, Carol MD

4060 4th Ave Ste 310

San Diego, CA 92103

(619) 297-4707

Provider ID: 56016

License: G75788

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 281

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

present. Accepting New Members: Yes

Vapnek, Evan MD

4033 3rd Ave Ste 400

San Diego, CA 92103

(619) 299-0670

Provider ID: 65497

License: G75357

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92123

Dato, Paul MD

3444 Kearny Villa Rd Ste 201

San Diego, CA 92123

(858) 430-1101

Provider ID: 269141

License: A43540

Credentials and/or board

certification: No

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Gaylis, Franklin MD

5395 Ruffin Rd Ste 202

San Diego, CA 92123

(858) 569-7800

Provider ID: 119549

License: A46251

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Keiller, Danny MD

3444 Kearny Villa Rd Ste 202

San Diego, CA 92123

(619) 299-0670

Provider ID: 243958

License: C32092

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Roberts, James MD

3444 Kearny Villa Rd Ste 201

San Diego, CA 92123

(858) 430-1101

Provider ID: 270010

License: G59945

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 282

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SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Vapnek, Evan MD

3444 Kearny Villa Rd Ste 201

San Diego, CA 92123

(858) 430-1101

Provider ID: 270006

License: G75357

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 283

Page 306: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS GREATER TRI CITIES IPA MEDICAL GROUP INC

AFFILIATED HOSPITALS

Above are hospitals you may

visit through this Medical

Group. For a complete listing

of hospital affiliations or to

access another hospital, refer

to page 1319. You will need to

coordinate with your PCP

and/or Medical Group. For

questions, call Blue Shield

Promise Cal MediConnect

Plan Customer Care.

PRIMARY CARE PHYSICIANS

Family Practice

CARLSBAD

92008

Ajir, Mahyar DO

2801 Jefferson St

Carlsbad, CA 92008

(760) 729-4952

Provider ID: 55698

License: 20A6683

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Etedali, Elaheh DO

2801 Jefferson St

Carlsbad, CA 92008

(760) 729-4952

Provider ID: 55545

License: 20A6701

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Perez, Ronald MD

1207 Carlsbad Village Dr Ste A

Carlsbad, CA 92008

(760) 896-3030

Provider ID: 215895

License: A132584

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN MARCOS

92078

Halim, Neil MD

1030 La Bonita Dr Ste 316

San Marcos, CA 92078

(760) 744-9626

Provider ID: 54487

License: C53327

Credentials and/or board

certification: No

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 284

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SAN DIEGO COUNTY MEDICAL GROUPS GREATER TRI CITIES IPA MEDICAL GROUP INC

Accepting New Members: Yes is limited access or when certification: No

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Arabic,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

VISTA

92081

Clark, Ma Belen MD

1954 Via Ctr Ste B

Vista, CA 92081

(760) 529-9700

Provider ID: 108704

License: A100202

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

accessibility indicators are not

present.

92083

Falconio, Linda MD

2067 W Vista Way Ste 130

Vista, CA 92083

(760) 631-4000

Provider ID: 92481

License: G37851

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Hurd, Melissa MD

161 Thunder Dr Ste 103

Vista, CA 92083

(760) 758-1988

Provider ID: 49432

License: A61672

Credentials and/or board

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92084

Fatland, Sarah DO

1000 Vale Terrace Dr

Vista, CA 92084

(760) 631-5000

Provider ID: 278889

License: 20A18374

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 285

Page 308: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS GREATER TRI CITIES IPA MEDICAL GROUP INC

present. License: A52193 office to discuss their

General Practice

ESCONDIDO

92025

Watson, Thomas MD

303 S Juniper St

Escondido, CA 92025

(760) 480-9051

Provider ID: 125694

License: A52193

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Watson, Thomas MD

301 E Washington Ave Ste B

Escondido, CA 92025

(760) 480-9051

Provider ID: 62912

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

VISTA

92083

Oliva, Carlos MD

969 S Santa Fe Ave Ste A

Vista, CA 92083

(760) 941-7050

Provider ID: 129919

License: A40155

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Smith, Gregory MD

161 Thunder Dr Ste 207

Vista, CA 92083

(760) 598-8410

Provider ID: 49457

License: G48979

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Internal Medicine

CARLSBAD

92009

Chong, Maribeth MD

6260 El Camino Real Ste 105

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 286

Page 309: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS GREATER TRI CITIES IPA MEDICAL GROUP INC

Carlsbad, CA 92009

(760) 434-6060

Provider ID: 108632

License: C51324

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Chong, Yoo Jin MD

6260 El Camino Real Ste 105

Carlsbad, CA 92009

(760) 434-6060

Provider ID: 108636

License: G86822

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Korean

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

OCEANSIDE

92056

Curran, Perrin MD

3601 Vista Way Ste 201

Oceanside, CA 92056

(760) 945-1894

Provider ID: 49427

License: G83073

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Ibrahim, Nagi MD

3231 Waring Ct Ste K

Oceanside, CA 92056

(760) 630-4499

Provider ID: 123114

License: A75003

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Lawson, Catherine MD

3230 Waring Ct Ste J

Oceanside, CA 92056

(760) 941-4498

Provider ID: 49438

License: G65272

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B; Members

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 287

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SAN DIEGO COUNTY MEDICAL GROUPS GREATER TRI CITIES IPA MEDICAL GROUP INC

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92058

Lizotte, Paul DO

115 N El Camino Real Ste A

Oceanside, CA 92058

(760) 330-5055

Provider ID: 276640

License: 20A6147

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

VISTA

92081

Clancy, Tara DO

2375 S Melrose Dr

Vista, CA 92081

(760) 305-1900

Provider ID: 107352

License: 20A9695

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92083

Bloom, Irving MD

130 Cedar Rd # 310

Vista, CA 92083

(760) 630-9095

Provider ID: 49408

License: G32967

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: German,

Japanese

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SPECIALISTS

Members may not self-refer to

any of the specialists listed

below. To receive covered

services from a specialist you

must receive a referral from

your primary care physician.

Cardiology

OCEANSIDE

92056

Rajamanickam, Anitha MD

3907 Waring Rd Ste 3

Oceanside, CA 92056

(760) 224-7766

Provider ID: 270156

License: A137462

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 288

Page 311: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS GREATER TRI CITIES IPA MEDICAL GROUP INC

PTA: No

Other Language: Hindi,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

VISTA

92083

Bui, Hanh MD

2067 W Vista Way Ste 225

Vista, CA 92083

(760) 630-2550

Provider ID: 109034

License: A79185

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Chinese,

Spanish, Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Cardiovascular Disease

OCEANSIDE

92056

Kabra, Ashish MD

3909 Waring Rd Ste A

Oceanside, CA 92056

(760) 630-0255

Provider ID: 122480

License: A122620

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN MARCOS

92078

Moussavian, Mehran DO

955 Boardwalk Ste 100

San Marcos, CA 92078

(619) 616-2100

Provider ID: 129105

License: 20A7241

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Dermatology

OCEANSIDE

92056

Angra, Kunal MD

3629 Vista Way

Oceanside, CA 92056

(760) 757-7546

Provider ID: 272503

License: A161745

Credentials and/or board

certification: No

Accepting New Members: Yes

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 289

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SAN DIEGO COUNTY MEDICAL GROUPS GREATER TRI CITIES IPA MEDICAL GROUP INC

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Gray, Jayla MD

3629 Vista Way

Oceanside, CA 92056

(760) 757-7546

Provider ID: 278763

License: A169832

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Hospice and Palliative

Medicine

SAN MARCOS

92069

Pasha, Sabiha MD

838 Nordahl Rd Ste 300

San Marcos, CA 92069

(760) 747-8935

Provider ID: 278960

License: C50413

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: German,

Spanish, Urdu

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Nephrology

CARLSBAD

92011

Choudry, Bilal MD

6010 Hidden Valley Rd Ste 200

Carlsbad, CA 92011

(760) 631-3000

Provider ID: 85292

License: A114607

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Urdu

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Wang, Chunyang MD

6010 Hidden Valley Rd Ste 200

Carlsbad, CA 92011

(760) 631-3000

Provider ID: 84398

License: A105660

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 290

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SAN DIEGO COUNTY MEDICAL GROUPS GREATER TRI CITIES IPA MEDICAL GROUP INC

Other Language: Mandarin,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Neurology

Gualberto, Gary MD

6010 Hidden Valley Rd Ste 200

Carlsbad, CA 92011

(760) 631-3000

Provider ID: 103158

License: C138319

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Oh, Irene MD

6010 Hidden Valley Rd Ste 200

Carlsbad, CA 92011

(760) 631-3000

Provider ID: 52430

License: A106450

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Pham, Alise DO

6010 Hidden Valley Rd Ste 200

Carlsbad, CA 92011

(760) 631-3000

Provider ID: 278296

License: 20A18259

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Obstetrics / Gynecology

OCEANSIDE

92056

Penvose-yi, Jan MD

3998 Vista Way Ste C

Oceanside, CA 92056

(760) 385-8008

Provider ID: 88524

License: C132992

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 291

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SAN DIEGO COUNTY MEDICAL GROUPS GREATER TRI CITIES IPA MEDICAL GROUP INC

Suntay, Berk MD

3998 Vista Way Ste C

Oceanside, CA 92056

(760) 941-1440

Provider ID: 278754

License: A124008

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

VISTA

92083

Clarkson, Chunjai MD

145 Thunder Dr

Vista, CA 92083

(760) 941-9002

Provider ID: 247862

License: G73471

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Ebrahimi Adib, Tannaz MD

2067 W Vista Way Ste 160

Vista, CA 92083

(760) 990-7585

Provider ID: 97633

License: A121761

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Persian

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92084

Leon, Josue MD

1000 Vale Terrace Dr

Vista, CA 92084

(760) 631-5000

Provider ID: 278976

License: A80635

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Ophthalmology

ENCINITAS

92024

Johnston, Eric MD

477 N El Camino Real Ste C202

Encinitas, CA 92024

(760) 631-3500

Provider ID: 278613

License: C169344

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 292

Page 315: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS GREATER TRI CITIES IPA MEDICAL GROUP INC

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Otolaryngology

OCEANSIDE

92056

Carroll, Sarah MD

3907 Waring Rd Ste 1

Oceanside, CA 92056

(760) 724-8749

Provider ID: 278735

License: A117013

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

VISTA

92083

Kushnaryov, Anton MD

2023 W Vista Way Ste J

Vista, CA 92083

(760) 726-2440

Provider ID: 117871

License: A114550

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Podiatrist

ENCINITAS

92024

Hatfield, James DPM

501 N El Camino Real Ste 201

Encinitas, CA 92024

(760) 436-8667

Provider ID: 99314

License: DPM1834

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Radiation Oncology

SAN DIEGO

92127

Bruggeman, Andrew MD

16918 Dove Canyon Rd Ste

103

San Diego, CA 92127

(858) 649-5100

Provider ID: 276717

License: A126549

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 293

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SAN DIEGO COUNTY MEDICAL GROUPS GREATER TRI CITIES IPA MEDICAL GROUP INC

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Surgery General

VISTA

92081

Fierer, Adam MD

2385 S Melrose Dr

Vista, CA 92081

(760) 300-3647

Provider ID: 86667

License: G69685

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Grove, Jay MD

2385 S Melrose Dr

Vista, CA 92081

(760) 300-3647

Provider ID: 53850

License: A60426

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Hanna, Karen MD

2385 S Melrose Dr

Vista, CA 92081

(760) 300-3647

Provider ID: 87126

License: G88851

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Surgery Orthopedic

ENCINITAS

92024

Afra, Robert MD

317 N El Camino Real Ste 405

Encinitas, CA 92024

(760) 994-2663

Provider ID: 89641

License: A96247

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 294

Page 317: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS GREATER TRI CITIES IPA MEDICAL GROUP INC

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Urology

OCEANSIDE

92056

Phillips, Jason MD

3609 Vista Way

Oceanside, CA 92056

(760) 637-2500

Provider ID: 85963

License: A129806

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 295

Page 318: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

AFFILIATED HOSPITALS

Above are hospitals you may

visit through this Medical

Group. For a complete listing

of hospital affiliations or to

access another hospital, refer

to page 1319. You will need to

coordinate with your PCP

and/or Medical Group. For

questions, call Blue Shield

Promise Cal MediConnect

Plan Customer Care.

PRIMARY CARE PHYSICIANS

Family Practice

ALPINE

91901

Flores, Jill MD

1620 Alpine Blvd Ste 110

Alpine, CA 91901

(619) 662-4100

Provider ID: 269820

License: A77198

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

CAMPO

91906

Rogers, Matthew DO

1388 Buckman Springs Rd

Campo, CA 91906

(619) 662-4100

Provider ID: 277482

License: 20A18400

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

CARLSBAD

92009

Bista, Madalasa MD

1905 Calle Barcelona Ste 211

Carlsbad, CA 92009

(858) 799-0933

Provider ID: 269570

License: A145628

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Nepali

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

CHULA VISTA

91910

Alb, Ovidiu MD

480 4th Ave Ste 202

Chula Vista, CA 91910

(619) 427-3361

Provider ID: 215100

License: C52597

Credentials and/or board

certification: No

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 296

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Accepting New Members: Yes accessibility indicators are not certification: No

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Romanian,

Spanish, Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Alb, Simona MD

480 4th Ave Ste 202

Chula Vista, CA 91910

(619) 427-3361

Provider ID: 215204

License: A98085

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Romanian,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

present.

Aljawadi, Georgia DO

480 4th Ave Ste 202

Chula Vista, CA 91910

(619) 427-3361

Provider ID: 215130

License: 20A11376

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish,

Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Mandoyan, Austin MD

678 3rd Ave

Chula Vista, CA 91910

(619) 662-4100

Provider ID: 277450

License: A161682

Credentials and/or board

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Polak, Clara MD

480 4th Ave Ste 202

Chula Vista, CA 91910

(619) 427-3361

Provider ID: 128074

License: A66649

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 297

Page 320: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Other Language: Spanish 480 Fourth Ave Ste 202

Cultural Competency: NR Chula Vista, CA 91910

Rabago, Maurellen MD Accessibility: B; Members (619) 427-3361

480 Fourth Ave Ste 202 should call the provider’s Provider ID: 252813

Chula Vista, CA 91910 office to discuss their License: A122649

(619) 427-3361 accessibility needs when there Credentials and/or board

Provider ID: 246730 is limited access or when certification: No

License: A146307 accessibility indicators are not Accepting New Members: No

Credentials and/or board present. Hours: M-SA 9AM-5PM

certification: No PTA: No

Accepting New Members: No Cultural Competency: NR

Hours: M-SA 9AM-5PM Whitley, Nicholas MD Accessibility: B; Members

PTA: No 678 3rd Ave should call the provider’s

Cultural Competency: NR Chula Vista, CA 91910 office to discuss their

Accessibility: B; Members (619) 662-4100 accessibility needs when there

should call the provider’s Provider ID: 253188 is limited access or when

office to discuss their License: A118250 accessibility indicators are not

accessibility needs when there Credentials and/or board present.

is limited access or when certification: No

accessibility indicators are not Accepting New Members: Yes 91911 present. Hours: M-SA 9AM-5PM

PTA: Yes Elsayed, Mohammed MD

Other Language: Spanish 330 Oxford St Ste 106

Stillwell, Carla MD Cultural Competency: NR Chula Vista, CA 91911

480 4th Ave Ste 202 Accessibility: B; Members (619) 409-1802

Chula Vista, CA 91910 should call the provider’s Provider ID: 126700

(619) 427-3361 office to discuss their License: A100765

Provider ID: 215254 accessibility needs when there Credentials and/or board

License: A114687 is limited access or when certification: No

Credentials and/or board accessibility indicators are not Accepting New Members: Yes

certification: Yes present. Hours: M-SA 9AM-5PM

Accepting New Members: Yes PTA: Yes

Hours: M-SA 9AM-5PM Other Language: Arabic,

PTA: Yes Yelanich, Melissa MD German, Spanish

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 298

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Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

EL CAJON

92019

Almansour, Mumtaz MD

165 S 1st St

El Cajon, CA 92019

(619) 312-0347

Provider ID: 255797

License: A55926

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Kurdish, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

PTA: No

Korkis, Ebtissam MD Other Language: Arabic,

1530 Jamacha Rd Ste E-f Mandarin

El Cajon, CA 92019 Cultural Competency: NR

(619) 441-9200 Accessibility: B; Members

Provider ID: 126908 should call the provider’s

License: A89767 office to discuss their

Credentials and/or board accessibility needs when there

certification: No is limited access or when

Accepting New Members: No accessibility indicators are not

Hours: M-SA 9AM-5PM present.

PTA: No

Other Language: Arabic, 92020 French, Kurdish

Cultural Competency: NR Almansour, Mumtaz MD

Accessibility: B; Members 330 S Magnolia Ave Ste 101

should call the provider’s El Cajon, CA 92020

office to discuss their (619) 593-3007

accessibility needs when there Provider ID: 126614

is limited access or when License: A55926

accessibility indicators are not Credentials and/or board

present. certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

Rouel, Linda MD PTA: Yes

860 Jamacha Rd Ste 107 Other Language: Arabic,

El Cajon, CA 92019 Kurdish, Spanish

(619) 456-9920 Cultural Competency: NR

Provider ID: 126697 Accessibility: B; Members

License: A107575 should call the provider’s

Credentials and/or board office to discuss their

certification: No accessibility needs when there

Accepting New Members: Yes is limited access or when

Hours: M-SA 9AM-5PM accessibility indicators are not

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 299

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present.

Dominguez, Dennis MD

875 El Cajon Blvd

El Cajon, CA 92020

(619) 441-3550

Provider ID: 277660

License: G43179

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Mansour, Wasim DO

330 S Magnolia Ave Ste 101

El Cajon, CA 92020

(619) 593-3007

Provider ID: 244427

License: 20A15860

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92021

Jalisi, Nejat MD

1320 E Madison Ave

El Cajon, CA 92021

(619) 456-9800

Provider ID: 126907

License: A105304

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Farsi, Spanish, Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Putrus, Ramiz MD

1032 Broadway

El Cajon, CA 92021

(619) 795-5991

Provider ID: 265252

License: A68184

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

FALLBROOK

92028

Deel, Margaret MD

593 E Elder St Ste B

Fallbrook, CA 92028

(760) 723-5900

Provider ID: 245717

License: C51529

Credentials and/or board

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 300

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certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA JOLLA

92037

Bista, Madalasa MD

9850 Genesee Ave Ste 320

La Jolla, CA 92037

(858) 864-9800

Provider ID: 269568

License: A145628

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Nepali

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Canelo, Nicholas MD

7855 Ivanhoe Ave Ste 110

La Jolla, CA 92037

(858) 554-1212

Provider ID: 207389

License: A145725

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Kuperman, Ilan MD

9850 Genesee Ave Ste 320

La Jolla, CA 92037

(858) 554-1212

Provider ID: 126909

License: A87018

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Morris, Maisa MD

9850 Genesee Ave Ste 320

La Jolla, CA 92037

(858) 554-1212

Provider ID: 275587

License: C170211

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 301

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Accessibility: B; Members 9850 Genesee Ave Ste 320

Morris, Maisa MD should call the provider’s La Jolla, CA 92037

7855 Ivanhoe Ave Ste 110 office to discuss their (858) 554-1212

La Jolla, CA 92037 accessibility needs when there Provider ID: 126717

(858) 554-1212 is limited access or when License: 20A6331

Provider ID: 275588 accessibility indicators are not Credentials and/or board

License: C170211 present. certification: No

Credentials and/or board Accepting New Members: No

certification: No Hours: M-SA 9AM-5PM

Accepting New Members: No Parrott, Emilia DO PTA: No

Hours: M-SA 9AM-5PM Contract terminated as of Other Language: Spanish

PTA: No 7/31/2021 Cultural Competency: NR

Cultural Competency: NR 9850 Genesee Ave Ste 320 Accessibility: B; Members

Accessibility: B; Members La Jolla, CA 92037 should call the provider’s

should call the provider’s (858) 554-1212 office to discuss their

office to discuss their Provider ID: 207395 accessibility needs when there

accessibility needs when there License: 20A16409 is limited access or when

is limited access or when Credentials and/or board accessibility indicators are not

accessibility indicators are not certification: Yes present.

present. Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No Taylor, Susan MD

Maxson, Christyanne MD Other Language: Polish Contract terminated as of

7855 Ivanhoe Ave Ste 111 Cultural Competency: NR 7/31/2021

La Jolla, CA 92037 Accessibility: B; Members 9850 Genesee Ave Ste 320

(858) 554-1212 should call the provider’s La Jolla, CA 92037

Provider ID: 258329 office to discuss their (858) 554-1212

License: C51943 accessibility needs when there Provider ID: 126718

Credentials and/or board is limited access or when License: G55574

certification: No accessibility indicators are not Credentials and/or board

Accepting New Members: No present. certification: No

Hours: M-SA 9AM-5PM Accepting New Members: Yes

PTA: No Hours: M-SA 9AM-5PM

Cultural Competency: NR Switzer, Jamie DO PTA: No

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 302

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Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Tootell, Rhodaline MD

9850 Genesee Ave Ste 320

La Jolla, CA 92037

(858) 554-1212

Provider ID: 265550

License: C160215

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Filipino,

Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA MESA

91942

Gurtch, Tim MD

Contract terminated as of

7/31/2021

8875 La Mesa Blvd Ste C

La Mesa, CA 91942

(619) 668-8100

Provider ID: 126902

License: C50806

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Russian,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

NATIONAL CITY

91950

Sevilla, Marianito MD

2340 E 8th St Ste D

National City, CA 91950

(619) 470-7007

Provider ID: 126703

License: A37097

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Tagalog

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Snook, Brian DO

2400 E 8th St

National City, CA 91950

(619) 662-4100

Provider ID: 265488

License: 20A11518

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 303

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

is limited access or when

accessibility indicators are not

present.

Trimor-tamoria, Maria Flora

MD

2240 E Plaza Blvd Ste A

National City, CA 91950

(619) 267-5884

Provider ID: 126720

License: A55589

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish,

Tagalog

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Trimor-tamoria, Maria Flora

MD

502 Euclid Ave Ste 103

National City, CA 91950

(619) 267-5884

Provider ID: 277648

License: A55589

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

POWAY

92064

Magat, Patrocinia MD

15644 Pomerado Rd Ste 100

Poway, CA 92064

(858) 485-5111

Provider ID: 279684

License: A37781

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Chinese,

Spanish, Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92101

Bhalrhu, Puneet MD

555 W C St Ste 102

San Diego, CA 92101

(858) 554-1212

Provider ID: 252889

License: A158762

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Parrott, Emilia DO

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 304

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Contract terminated as of

7/31/2021

555 W C St Ste 102

San Diego, CA 92101

(858) 554-1212

Provider ID: 207396

License: 20A16409

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Polish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92103

Bhalrhu, Puneet MD

3900 5th Ave Ste 110

San Diego, CA 92103

(858) 554-1212

Provider ID: 252888

License: A158762

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Buchner, William MD

3900 5th Ave Ste 110

San Diego, CA 92103

(858) 554-1212

Provider ID: 126892

License: A109750

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92105

Schumaker, Edward DO

4060 Fairmount Ave

San Diego, CA 92105

(619) 280-4213

Provider ID: 265355

License: 20A6433

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Senethong, Sombath MD

4060 Fairmount Ave

San Diego, CA 92105

(619) 584-1612

Provider ID: 265357

License: A36779

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Lao,

Spanish, Tagalog, Thai

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 305

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Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92109

Bahmanpour, Kaveh MD

3023 Bunker Hill St Ste 106

San Diego, CA 92109

(858) 270-0010

Provider ID: 265368

License: A109450

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92111

Ahn, Edward MD

7750 Dagget St Ste 108 Accessibility: B, W; Members

San Diego, CA 92111 should call the provider’s

(858) 571-1004 office to discuss their

Provider ID: 126613 accessibility needs when there

License: A38304 is limited access or when

Credentials and/or board accessibility indicators are not

certification: No present.

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes Rim, Choon MD

Other Language: Korean 7825 Engineer Rd Ste 101

Cultural Competency: NR San Diego, CA 92111

Accessibility: B; Members (858) 277-7111

should call the provider’s Provider ID: 126693

office to discuss their License: C50815

accessibility needs when there Credentials and/or board

is limited access or when certification: Yes

accessibility indicators are not Accepting New Members: Yes

present. Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Korean,

Park, Ro Jong MD Spanish

7825 Engineer Rd Ste 101 Cultural Competency: NR

San Diego, CA 92111 Accessibility: B; Members

(858) 277-7111 should call the provider’s

Provider ID: 126626 office to discuss their

License: C51913 accessibility needs when there

Credentials and/or board is limited access or when

certification: No accessibility indicators are not

Accepting New Members: Yes present.

Hours: M-SA 9AM-5PM

PTA: Yes 92113 Other Language: Korean

Cultural Competency: NR Alvarez-estrada, Miguel MD

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 306

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

3177 Ocean View Blvd office to discuss their Provider ID: 274820

San Diego, CA 92113 accessibility needs when there License: A162332

(619) 232-5922 is limited access or when Credentials and/or board

Provider ID: 270466 accessibility indicators are not certification: No

License: A157505 present. Accepting New Members: Yes

Credentials and/or board Hours: M-SA 9AM-5PM

certification: No PTA: No

Accepting New Members: Yes Kaufhold, Anne MD Cultural Competency: NR

Hours: M-SA 9AM-5PM 3177 Ocean View Blvd Accessibility: B; Members

PTA: No San Diego, CA 92113 should call the provider’s

Cultural Competency: NR (619) 662-4100 office to discuss their

Accessibility: B; Members Provider ID: 246615 accessibility needs when there

should call the provider’s License: A88893 is limited access or when

office to discuss their Credentials and/or board accessibility indicators are not

accessibility needs when there certification: No present.

is limited access or when Accepting New Members: Yes

accessibility indicators are not Hours: M-SA 9AM-5PM

present. PTA: Yes Shihata, Alfred MD

Other Language: Arabic, 3802 National Ave

Spanish San Diego, CA 92113

Dappen, Amanda MD Cultural Competency: NR (619) 264-2591

3177 Ocean View Blvd Accessibility: B; Members Provider ID: 126708

San Diego, CA 92113 should call the provider’s License: A37090

(619) 662-4100 office to discuss their Credentials and/or board

Provider ID: 246965 accessibility needs when there certification: No

License: A153414 is limited access or when Accepting New Members: Yes

Credentials and/or board accessibility indicators are not Hours: M-SA 9AM-5PM

certification: No present. PTA: Yes

Accepting New Members: Yes Other Language: Arabic,

Hours: M-SA 9AM-5PM Spanish

PTA: No Morales, Alejandra MD Cultural Competency: NR

Cultural Competency: NR 3177 Ocean View Blvd Accessibility: B, W; Members

Accessibility: B; Members San Diego, CA 92113 should call the provider’s

should call the provider’s (619) 662-4100 office to discuss their

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 307

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

accessibility needs when there Credentials and/or board is limited access or when

is limited access or when certification: No accessibility indicators are not

accessibility indicators are not Accepting New Members: Yes present.

present. Hours: M-SA 9AM-5PM

PTA: No 92115

92114 Cultural Competency: NR

Accessibility: B; Members Dao, Viet MD

Fambro, Cynthia MD should call the provider’s 4616 El Cajon Blvd Ste 9

950 S Euclid Ave office to discuss their San Diego, CA 92115

San Diego, CA 92114 accessibility needs when there (619) 583-0553

(619) 662-4100 is limited access or when Provider ID: 126681

Provider ID: 245427 accessibility indicators are not License: A96409

License: A153223 present. Credentials and/or board

Credentials and/or board certification: No

certification: No Accepting New Members: Yes

Accepting New Members: Yes Wyatt, Tynan MD Hours: M-SA 9AM-5PM

Hours: M-SA 9AM-5PM Contract terminated as of PTA: No

PTA: No 7/31/2021 Cultural Competency: NR

Cultural Competency: NR 950 S Euclid Ave Accessibility: B; Members

Accessibility: B; Members San Diego, CA 92114 should call the provider’s

should call the provider’s (619) 662-4100 office to discuss their

office to discuss their Provider ID: 253198 accessibility needs when there

accessibility needs when there License: A146408 is limited access or when

is limited access or when Credentials and/or board accessibility indicators are not

accessibility indicators are not certification: No present.

present. Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No Le, Tram MD

Scott, Lagina MD Other Language: Spanish 5507 El Cajon Blvd # L

292 Euclid Ave Ste 210 Cultural Competency: NR San Diego, CA 92115

San Diego, CA 92114 Accessibility: B; Members (619) 286-2789

(619) 662-4100 should call the provider’s Provider ID: 126910

Provider ID: 277458 office to discuss their License: A105829

License: A160489 accessibility needs when there Credentials and/or board

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 308

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish,

Vietnamese

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92116

Parrott, Emilia DO

Contract terminated as of

8/31/2021

4142 Adams Ave Ste 102

San Diego, CA 92116

(858) 554-1212

Provider ID: 278378

License: 20A16409

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Polish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Taylor, Susan MD

Contract terminated as of

8/31/2021

4142 Adams Ave Ste 102

San Diego, CA 92116

(858) 554-1212

Provider ID: 278393

License: G55574

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92117

Hamidi, Mahshid MD

5222 Balboa Ave Ste 31

San Diego, CA 92117

(858) 565-6394

Provider ID: 126903

License: A63702

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Faroese,

Farsi, Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Yuen, Selene MD

4282 Genesee Ave Ste 102

San Diego, CA 92117

(858) 598-6789

Provider ID: 126722

License: A99615

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 309

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should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92120

Marquis, Paul MD

Contract terminated as of

6/30/2021

6386 Alvarado Ct Ste 101

San Diego, CA 92120

(858) 554-1212

Provider ID: 275606

License: G161976

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Shamani, Azam MD

5555 Reservoir Dr Ste 312

San Diego, CA 92120

(619) 639-7285

Provider ID: 215260

License: A109713

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Faroese,

Farsi, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92121

Dembo Smeaton, Elena MD

Contract terminated as of

8/31/2021

4520 Executive Dr Ste 105

San Diego, CA 92121

(858) 450-5900

Provider ID: 126686

License: A82203

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Russian

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92122

Jenkin, Frederick DO

3562 Governor Dr Ste 1

San Diego, CA 92122

(858) 774-5157

Provider ID: 255591

License: 20A5034

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92130

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 310

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Bista, Madalasa MD Cultural Competency: NR

12843 El Camino Real Ste 203 Accessibility: B; Members

San Diego, CA 92130 should call the provider’s

(858) 554-1212 office to discuss their

Provider ID: 269569 accessibility needs when there

License: A145628 is limited access or when

Credentials and/or board accessibility indicators are not

certification: No present.

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No Szmidt, Maria MD

Other Language: Nepali 12395 El Camino Real Ste 100

Cultural Competency: NR San Diego, CA 92130

Accessibility: B; Members (858) 259-5655

should call the provider’s Provider ID: 209767

office to discuss their License: A52235

accessibility needs when there Credentials and/or board

is limited access or when certification: No

accessibility indicators are not Accepting New Members: Yes

present. Hours: M-SA 9AM-5PM

PTA: No

Other Language: Polish,

Soliman, Youstina MD Russian, Spanish

12843 El Camino Real Ste 203 Cultural Competency: NR

San Diego, CA 92130 Accessibility: B; Members

(858) 554-1212 should call the provider’s

Provider ID: 259840 office to discuss their

License: C160848 accessibility needs when there

Credentials and/or board is limited access or when

certification: No accessibility indicators are not

Accepting New Members: Yes present.

Hours: M-SA 9AM-5PM

PTA: No 92154 Other Language: Arabic

Villa, Maria MD

655 Saturn Blvd Ste J

San Diego, CA 92154

(619) 575-4442

Provider ID: 214256

License: A86224

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish,

Tagalog

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN YSIDRO

92173

Alvarez-estrada, Miguel MD

4004 Beyer Blvd

San Ysidro, CA 92173

(619) 662-4100

Provider ID: 269585

License: A157505

Credentials and/or board

certification: No

Accepting New Members: Yes

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 311

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Hours: M-SA 9AM-5PM 4004 Beyer Blvd Accessibility: B; Members

PTA: No San Ysidro, CA 92173 should call the provider’s

Cultural Competency: NR (619) 662-4100 office to discuss their

Accessibility: B; Members Provider ID: 242432 accessibility needs when there

should call the provider’s License: A152166 is limited access or when

office to discuss their Credentials and/or board accessibility indicators are not

accessibility needs when there certification: No present.

is limited access or when Accepting New Members: Yes

accessibility indicators are not Hours: M-SA 9AM-5PM

present. PTA: No Fellman, Anna MD

Other Language: Spanish 4004 Beyer Blvd

Cultural Competency: NR San Ysidro, CA 92173

Alvarez-estrada, Miguel MD Accessibility: B; Members (619) 662-4100

4050 Beyer Blvd should call the provider’s Provider ID: 279211

San Ysidro, CA 92173 office to discuss their License: A138371

(619) 205-1967 accessibility needs when there Credentials and/or board

Provider ID: 270465 is limited access or when certification: No

License: A157505 accessibility indicators are not Accepting New Members: No

Credentials and/or board present. Hours: M-SA 9AM-5PM

certification: No PTA: No

Accepting New Members: Yes Cultural Competency: NR

Hours: M-SA 9AM-5PM Croughan, Stephen MD Accessibility: B; Members

PTA: No 4004 Beyer Blvd should call the provider’s

Cultural Competency: NR San Ysidro, CA 92173 office to discuss their

Accessibility: B; Members (619) 662-4100 accessibility needs when there

should call the provider’s Provider ID: 245361 is limited access or when

office to discuss their License: A41669 accessibility indicators are not

accessibility needs when there Credentials and/or board present.

is limited access or when certification: No

accessibility indicators are not Accepting New Members: Yes

present. Hours: M-SA 9AM-5PM Ferraiolo, Natalie MD

PTA: No 4004 Beyer Blvd

Other Language: Spanish San Ysidro, CA 92173

Caine, Teah MD Cultural Competency: NR (619) 662-4100

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 312

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Provider ID: 245471 is limited access or when certification: No

License: A152372

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Hernandez, Ralph MD

3364 Beyer Blvd

San Ysidro, CA 92173

(619) 662-4100

Provider ID: 245261

License: C42207

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

accessibility indicators are not

present.

Navarro, Vanessa MD

3364 Beyer Blvd Ste 103

San Ysidro, CA 92173

(619) 662-4100

Provider ID: 254845

License: A113624

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Otanez Cervantes, Jorge MD

4004 Beyer Blvd

San Ysidro, CA 92173

(619) 662-4100

Provider ID: 255977

License: A153220

Credentials and/or board

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Rodriguez, Allen MD

4004 Beyer Blvd

San Ysidro, CA 92173

(619) 662-4100

Provider ID: 253172

License: A163327

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 313

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Rajaipour, Negin MD

3364 Beyer Blvd

San Ysidro, CA 92173

(619) 662-4100

Provider ID: 245396

License: A145480

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Snyder, Christopher DO

4004 Beyer Blvd

San Ysidro, CA 92173

(619) 662-4100

Provider ID: 245316

License: 20A7502

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Sweet, Patrick MD

4004 Beyer Blvd

San Ysidro, CA 92173

(619) 662-4100

Provider ID: 253751

License: A101827

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

VISTA

92084

Neff, Jennifer MD

204 S Santa Fe Ave

Vista, CA 92084

(858) 554-1212

Provider ID: 276971

License: A80392

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Other Language: French,

Hmong

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

General Practice

CARLSBAD

92009

Alexander, Sandra MD

1905 Calle Barcelona Ste 211

Carlsbad, CA 92009

(858) 554-1212

Provider ID: 272563

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 314

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

License: C169320

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Portuguese,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

DEL MAR

92014

Kremer, Arnold DO

1349 Camino Del Mar Ste B

Del Mar, CA 92014

(858) 925-8233

Provider ID: 128153

License: 20A4242

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: French

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ENCINITAS

92024

Farsad, Ramin MD

477 N El Camino Real Ste A100

Encinitas, CA 92024

(760) 943-9111

Provider ID: 252942

License: G80982

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Farsi,

Fataleka, Turkish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ESCONDIDO

92025

Lopez, Irma MD

1035 E Grand Ave Ste 101

Escondido, CA 92025

(760) 480-4747

Provider ID: 259228

License: G57022

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA JOLLA

92037

Stern, Anna MD

9850 Genesee Ave Ste 320

La Jolla, CA 92037

(858) 554-1212

Provider ID: 126716

License: A88573

Credentials and/or board

certification: No

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 315

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Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

NATIONAL CITY

91950

Medina, Natalie MD

502 Euclid Ave Ste 306

National City, CA 91950

(619) 267-1168

Provider ID: 278264

License: A54817

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92105

Recalde, Francisco MD

3811 El Cajon Blvd

San Diego, CA 92105

(619) 284-5622

Provider ID: 126692

License: C41872

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92111

Vo, Duc MD

2418 Ulric St

San Diego, CA 92111

(858) 560-1226

Provider ID: 126721

License: A43289

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish,

Vietnamese

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92115

Dwabe, Kefah MD

4863 El Cajon Blvd # A

San Diego, CA 92115

(619) 286-9000

Provider ID: 126690

License: A94193

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Arabic,

Burmese, Cambodian, Thai

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 316

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

office to discuss their License: G42131 accessibility needs when there

accessibility needs when there Credentials and/or board is limited access or when

is limited access or when certification: No accessibility indicators are not

accessibility indicators are not Accepting New Members: Yes present.

present. Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish Mirkarimi, Morteza MD

Sidrick, Nadine MD Cultural Competency: NR 3863 Clairemont Dr

4440 Euclid Ave Ste C Accessibility: B; Members San Diego, CA 92117

San Diego, CA 92115 should call the provider’s (858) 483-5570

(619) 582-5105 office to discuss their Provider ID: 129195

Provider ID: 126709 accessibility needs when there License: A39662

License: G42131 is limited access or when Credentials and/or board

Credentials and/or board accessibility indicators are not certification: No

certification: No present. Accepting New Members: Yes

Accepting New Members: No Hours: M-SA 9AM-5PM

Hours: M-SA 9AM-5PM 92117 PTA: Yes

PTA: No Other Language: Farsi,

Other Language: Spanish Kidokoro, Yasuko MD Fataleka, Spanish

Cultural Competency: NR 5222 Balboa Ave Ste 31 Cultural Competency: NR

Accessibility: B; Members San Diego, CA 92117 Accessibility: B, W; Members

should call the provider’s (858) 277-9669 should call the provider’s

office to discuss their Provider ID: 259602 office to discuss their

accessibility needs when there License: A32727 accessibility needs when there

is limited access or when Credentials and/or board is limited access or when

accessibility indicators are not certification: No accessibility indicators are not

present. Accepting New Members: Yes present.

Hours: M-SA 9AM-5PM

PTA: No 92126 Sidrick, Nadine MD Other Language: Japanese

4690 El Cajon Blvd Cultural Competency: NR Razon, Annabelle MD

San Diego, CA 92115 Accessibility: B; Members 9190 Mira Mesa Blvd

(619) 662-4100 should call the provider’s San Diego, CA 92126

Provider ID: 279711 office to discuss their (858) 689-1814

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 317

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Provider ID: 126684

License: A42407

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish,

Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92128

Hegyi, Edit MD

16769 Bernardo Center Dr Ste

K13

San Diego, CA 92128

(760) 990-3523

Provider ID: 244768

License: A89002

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: French,

Hungarian

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92154

Borrero, Marcos MD

3490 Palm Ave

San Diego, CA 92154

(619) 423-5616

Provider ID: 126615

License: A38907

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Gerbatsch-bornemisza, Ildiko

MD

3490 Palm Ave

San Diego, CA 92154

(619) 423-5616

Provider ID: 126898

License: A63645

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Internal Medicine

ALPINE

91901

Mueller, Laurel DO

1620 Alpine Blvd Ste 110

Alpine, CA 91901

(619) 662-4100

Provider ID: 273666

License: 20A18030

Credentials and/or board

certification: No

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 318

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

CHULA VISTA

91910

Espinosa-melendez, Enrique

MD

480 4th Ave Ste 507

Chula Vista, CA 91910

(619) 477-7779

Provider ID: 126894

License: C42745

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: French,

Portuguese, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Fadhil, Ali MD

340 Fourth Ave Ste 9

Chula Vista, CA 91910

(619) 426-9731

Provider ID: 244515

License: A145663

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Mondragon, Gustavo MD

480 4th Ave Ste 500

Chula Vista, CA 91910

(619) 656-5252

Provider ID: 126917

License: A40640

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Pena, Jose MD

374 H St Ste 103

Chula Vista, CA 91910

(619) 691-1766

Provider ID: 126724

License: C50688

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 319

Page 342: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Hours: M-SA 9AM-5PM

PTA: No

Uwedjojevwe, Leticia MD

340 Fourth Ave Ste 10

Chula Vista, CA 91910

(619) 934-2215

Provider ID: 128020

License: A80329

Other Language: Spanish,

Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

Credentials and/or board

certification: No

accessibility needs when there

is limited access or when

Accepting New Members: Yes accessibility indicators are not

Hours: M-SA 9AM-5PM

PTA: No

present.

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

Lopez, Jose MD

2648 Main St Ste A

should call the provider’s Chula Vista, CA 91911

office to discuss their

accessibility needs when there

(619) 575-5000

Provider ID: 242483

is limited access or when License: A43301

accessibility indicators are not

present.

Credentials and/or board

certification: Yes

91911

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

De La Rosa, Renato MD

754 Medical Center Ct Ste 103

Chula Vista, CA 91911

(619) 397-5001

Provider ID: 265545

License: A65330

Other Language: Spanish,

Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

Credentials and/or board

certification: No

accessibility needs when there

is limited access or when

Accepting New Members: Yes accessibility indicators are not

present.

EL CAJON

92019

Rouel, Wadi MD

860 Jamacha Rd Ste 107

El Cajon, CA 92019

(619) 456-9920

Provider ID: 126698

License: C55979

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92020

Elias, Ramiz MD

231 W Main St Fl 2

El Cajon, CA 92020

(619) 631-7300

Provider ID: 127986

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 320

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

License: A99956

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Farsi, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Khamooshian, Kourosh MD

875 El Cajon Blvd

El Cajon, CA 92020

(619) 662-4100

Provider ID: 277695

License: A110901

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Spanish, Turkish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92021

Khanna, Poornima MD

1032 Broadway

El Cajon, CA 92021

(619) 795-5991

Provider ID: 229576

License: A70714

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Kannada

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Toulouie, Elahe MD

1580 N 2nd St

El Cajon, CA 92021

(619) 447-2425

Provider ID: 211606

License: A73141

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Armenian,

Farsi, German

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ENCINITAS

92024

Kalina, Mark MD

477 N El Camino Real Ste A200

Encinitas, CA 92024

(858) 766-6007

Provider ID: 278533

License: A49274

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 321

Page 344: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ESCONDIDO

92027

Al-asady, Noor DO

255 N Ash St Ste 101

Escondido, CA 92027

(619) 662-4100

Provider ID: 274264

License: 20A14791

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA JOLLA

92037

Ehrlich, Dennis MD

8950 Villa La Jolla Dr Ste C129

La Jolla, CA 92037

(858) 450-5900

Provider ID: 279136

License: G45623

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Hiser, Daniel MD

8950 Villa La Jolla Dr Ste C129

La Jolla, CA 92037

(858) 450-5900

Provider ID: 279078

License: G47397

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Perlman, Monica MD

9850 Genesee Ave Ste 320

La Jolla, CA 92037

(858) 554-1212

Provider ID: 126650

License: G70356

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Rana, Shaunak MD

7855 Ivanhoe Ave Ste 110

La Jolla, CA 92037

(858) 799-0933

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 322

Page 345: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Provider ID: 275763

License: A117404

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Wright, C Michael MD

9850 Genesee Ave Ste 320

La Jolla, CA 92037

(858) 554-1212

Provider ID: 269505

License: G58919

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Other Language: French

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA MESA

91942

Alamar, Ali MD

5565 Grossmont Center Dr Ste

105 Bldg 1

La Mesa, CA 91942

(619) 724-6644

Provider ID: 127921

License: A69613

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Prabaker, Venugopal MD

7339 El Cajon Blvd Ste I

La Mesa, CA 91942

(619) 698-0606

Provider ID: 126666

License: A42653

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Arabic,

Chinese, Polish, Russian,

Spanish, Tagalog, Tamil, Thai

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Shahbaz, Majid MD

8851 Center Dr Ste 408

La Mesa, CA 91942

(619) 583-1174

Provider ID: 252902

License: A50402

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Faroese,

Farsi, Tagalog

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 323

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Toulouie, Elahe MD

5358 Jackson Dr # 1

La Mesa, CA 91942

(619) 993-8996

Provider ID: 207406

License: A73141

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Armenian,

Farsi, German

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

NATIONAL CITY

91950

Bautista, Arwinnah MD

1430 E Plaza Blvd Ste E19a

National City, CA 91950

(619) 434-2813

Provider ID: 126891

License: C51221

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Tiangco, Irineo MD

2340 E 8th St Ste J

National City, CA 91950

(619) 479-0320

Provider ID: 265489

License: A52655

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish,

Tagalog

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92101

Haring, Kristen MD

555 W C St Ste 102

San Diego, CA 92101

(858) 333-4977

Provider ID: 277592

License: A64751

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 324

Page 347: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Lichtenstein, Bernard MD

250 Market St

San Diego, CA 92101

(619) 236-0111

Provider ID: 257297

License: A37396

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: German,

Hebrew, Polish, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92102

Nanduri, Ramachander MD

995 Gateway Center Way Ste

202

San Diego, CA 92102

(619) 264-3107

Provider ID: 213479

License: C50916

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Hindi,

Kannada, Spanish, Tamil,

Telugu

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92103

Haring, Kristen MD

3900 5th Ave Ste 110

San Diego, CA 92103

(858) 554-1212

Provider ID: 277201

License: A64751

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92105

Khanna, Poornima MD

4060 Fairmount Ave

San Diego, CA 92105

(619) 255-9155

Provider ID: 229575

License: A70714

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Kannada

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92113

Lichtenstein, Bernard MD

3802 National Ave

San Diego, CA 92113

(619) 264-2591

Provider ID: 128898

License: A37396

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 325

Page 348: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: German,

Hebrew, Polish, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92114

Carrera, Jorge MD

950 S Euclid Ave

San Diego, CA 92114

(619) 662-4100

Provider ID: 265682

License: G58033

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there License: A124891

is limited access or when

accessibility indicators are

Credentials and/or board

not certification: No

present. Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Hood, Rodney MD

292 Euclid Ave Ste 210

Other Language: Spanish,

Vietnamese

San Diego, CA 92114

(619) 262-7523

Provider ID: 265625

License: G27791

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

Credentials and/or board

certification: Yes

accessibility needs when there

is limited access or when

Accepting New Members: Yes accessibility indicators are not

Hours: M-SA 9AM-5PM

PTA: Yes

present.

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

Nguyen, Tue MD

4551 El Cajon Blvd

San Diego, CA 92115

(619) 280-7185

Provider ID: 276891

is limited access or when License: A49831

accessibility indicators are

present.

not Credentials and/or board

certification: No

92115

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Le, Charles MD

4440 Euclid Ave

San Diego, CA 92115

(619) 521-6812

Provider ID: 238373

Other Language: Vietnamese

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 326

Page 349: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

accessibility needs when there License: A47821 office to discuss their

is limited access or when

accessibility indicators are not

present.

Prathipati, Kumara MD

4276 54th Pl Ste B

San Diego, CA 92115

(619) 286-3222

Provider ID: 126671

License: A40438

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Hindi,

Spanish, Tagalog, Telugu

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Prathipati, Lakshmi MD

4276 54th Pl Ste B

San Diego, CA 92115

(619) 286-3222

Provider ID: 126669

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish,

Tagalog, Telugu

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Truong, Tu MD

5069 El Cajon Blvd

San Diego, CA 92115

(619) 583-8705

Provider ID: 243145

License: A50756

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Cambodian,

Spanish, Vietnamese

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Vo, Sony MD

4551 El Cajon Blvd

San Diego, CA 92115

(619) 280-7185

Provider ID: 276277

License: A49788

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92117

Toulouie, Elahe MD

4282 Genesee Ave Ste 204

San Diego, CA 92117

(619) 993-8996

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 327

Page 350: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Provider ID: 256898

License: A73141

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Armenian,

Farsi, German

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92121

Singhal, Bindu MD

5440 Morehouse Dr Ste 1700

San Diego, CA 92121

(858) 455-7657

Provider ID: 126711

License: A78248

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Hindi,

Punjabi, Spanish, Urdu

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92123

Elias, Ramiz MD

7695 Cardinal Ct Ste 375

San Diego, CA 92123

(858) 384-7072

Provider ID: 126699

License: A99956

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Farsi, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Guha Roy, Asim MD

4540 Kearny Villa Rd Ste 106

San Diego, CA 92123

(858) 430-6656

Provider ID: 257034

License: A62010

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Bengali,

Hindi, Malay, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92126

Fabella, Gabriel MD

10737 Camino Ruiz Ste 115

San Diego, CA 92126

(858) 695-1262

Provider ID: 126895

License: A48087

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: Yes

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 328

Page 351: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Other Language: Japanese,

Spanish, Tagalog

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN YSIDRO

92173

Avery, John DO

4004 Beyer Blvd

San Ysidro, CA 92173

(619) 662-4100

Provider ID: 242382

License: 20A13586

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Diaz-gonzalez, Vicente MD

4004 Beyer Blvd

San Ysidro, CA 92173

(619) 662-4100

Provider ID: 274812

License: A84160

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Dillon, Benedict MD

4050 Beyer Blvd

San Ysidro, CA 92173

(619) 662-4100

Provider ID: 270474

License: A111118

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Ogbonnaya-whittlesey,

Sandra MD

4004 Beyer Blvd

San Ysidro, CA 92173

(619) 662-4100

Provider ID: 273351

License: A122336

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Salerno, Mariana MD

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 329

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

4004 Beyer Blvd

San Ysidro, CA 92173

(619) 662-4100

Provider ID: 277445

License: A131021

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Sy, Ramon MD

3364 Beyer Blvd

San Ysidro, CA 92173

(619) 662-4100

Provider ID: 254295

License: A51843

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SANTEE

92071

Guerra, Jacqueline MD

120 Town Center Pkwy

Santee, CA 92071

(619) 445-6200

Provider ID: 277501

License: A151449

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

VISTA

92081

Rutman, Michael DO

2355 S Melrose Dr

Vista, CA 92081

(760) 598-0088

Provider ID: 246236

License: 20A4641

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Obstetrics / Gynecology

CHULA VISTA

91910

Reddy, Divya MD

678 Third Ave

Chula Vista, CA 91910

(619) 662-4100

Provider ID: 247279

License: A130224

Credentials and/or board

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 330

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certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Hindi,

Kannada, Telugu

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SPECIALISTS

Members may not self-refer to

any of the specialists listed

below. To receive covered

services from a specialist you

must receive a referral from

your primary care physician.

Advanced Heart Failure and

Transplant Cardiology

91914

Hoagland, Peter MD

890 Eastlake Pkwy Ste 205

Chula Vista, CA 91914

(858) 244-6800

Provider ID: 275446

License: G54598

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: French,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Jaski, Brian MD

890 Eastlake Pkwy Ste 205

Chula Vista, CA 91914

(858) 244-6800

Provider ID: 275474

License: G55011

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: French

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92123

Hoagland, Peter MD

3131 Berger Ave Ste 200

San Diego, CA 92123

(858) 244-6800

Provider ID: 275445

License: G54598

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: French,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Jaski, Brian MD

3131 Berger Ave Ste 200

San Diego, CA 92123

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 331

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

(858) 244-6800

Provider ID: 275473

License: G55011

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: French

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Allergy Immunology

LA JOLLA

92037

Jaffer, Adrian MD

9850 Genesee Ave Ste 420

La Jolla, CA 92037

(858) 457-3270

Provider ID: 65723

License: A25563

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92108

Alkatib, Rhonda MD

2655 Camino Del Rio N Ste 120

San Diego, CA 92108

(619) 286-6687

Provider ID: 268622

License: A163910

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Pendleton, Jennifer MD

2655 Camino Del Rio N Ste 120

San Diego, CA 92108

(619) 286-6687

Provider ID: 26514

License: A80748

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92131

Sharma, Kusum MD

10672 Wexford St Ste 280

San Diego, CA 92131

(858) 412-7362

Provider ID: 127875

License: A111243

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 332

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Other Language: Hindi,

Spanish, Urdu

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Anesthesiology Pain

Management

ALPINE

91901

Lao, Jesus MD

1392 Tavern Rd

Alpine, CA 91901

(619) 722-4270

Provider ID: 105586

License: A72729

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Chinese,

Mandarin, Spanish, Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

CARLSBAD

92011

Madhav, Sandip MD

6010 Hidden Valley Rd Ste 200

Carlsbad, CA 92011

(760) 631-3000

Provider ID: 265242

License: A128918

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Gujarati

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Truong, Ngoc DO

6010 Hidden Valley Rd Ste 110

Carlsbad, CA 92011

(760) 607-5350

Provider ID: 273552

License: 20A13556

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Special Expertise: HIV/AIDS

CHULA VISTA

91910

Truong, Ngoc DO

340 Fourth Ave Ste 19

Chula Vista, CA 91910

(619) 761-5308

Provider ID: 273553

License: 20A13556

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Vietnamese

Cultural Competency: NR

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 333

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Special Expertise: HIV/AIDS

ESCONDIDO

92029

Richardson, Henry MD

1340 W Valley Pkwy Ste 201

Escondido, CA 92029

(760) 607-5350

Provider ID: 268456

License: A105294

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA JOLLA

92037

Madhav, Sandip MD

9850 Genesee Ave Ste 530

La Jolla, CA 92037

(760) 631-3000

Provider ID: 277675

License: A128918

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Gujarati

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92103

Van Noord, Brandon MD

3969 4th Ave Ste 208

San Diego, CA 92103

(619) 849-5777

Provider ID: 207405

License: A113568

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Anesthesiology

CHULA VISTA

91910

Thompson, Sandra MD

786 Third Ave Ste B

Chula Vista, CA 91910

(619) 425-0797

Provider ID: 265270

License: G156943

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 334

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

is limited access or when License: 20A11914 office to discuss their

accessibility indicators are not

present.

ESCONDIDO

92025

Faruque, Tania MD

255 N Elm St Ste 101

Escondido, CA 92025

(760) 489-1876

Provider ID: 276163

License: A128513

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Khatibi, Nikan DO

160 N Date St

Escondido, CA 92025

(888) 873-6220

Provider ID: 270624

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA MESA

91942

Chien, Shelby MD

5360 Jackson Dr Ste 100

La Mesa, CA 91942

(619) 713-6514

Provider ID: 259680

License: C163846

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92103

Thompson, Sandra MD

4033 3rd Ave Ste 430

San Diego, CA 92103

(619) 578-3740

Provider ID: 270537

License: G156943

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92123

Chien, Shelby MD

5395 Ruffin Rd Ste 204

San Diego, CA 92123

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 335

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

(858) 571-3630

Provider ID: 259679

License: C163846

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92126

Grovey, Brittany MD

8901 Activity Rd Ste 100

San Diego, CA 92126

(858) 345-4646

Provider ID: 207388

License: A129072

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Lee, Gemayel MD

8901 Activity Rd Ste 100

San Diego, CA 92126

(858) 345-4646

Provider ID: 207399

License: A129129

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Audiologist

CARLSBAD

92008

Alvira, Providence MA

1820 Marron Rd Ste 102

Carlsbad, CA 92008

(760) 434-0125

Provider ID: 254558

License: AU1745

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Alvira, Providence MA

1820 Marron Rd Ste 102

Carlsbad, CA 92008

(760) 434-0125

Provider ID: 254558

License: HA3591

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 336

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

is limited access or when

accessibility indicators are not

present.

Herrera, Charity MA

1820 Marron Rd Ste 102

Carlsbad, CA 92008

(760) 434-0125

Provider ID: 253421

License: AU2110

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

CHULA VISTA

91910

Alvira, Providence MA

310 Third Ave Ste C11

Chula Vista, CA 91910

(619) 426-0841

Provider ID: 254553

License: HA3591

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Alvira, Providence MA

310 Third Ave Ste C11

Chula Vista, CA 91910

(619) 426-0841

Provider ID: 254553

License: AU1745

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Crawford, Joyce MS

310 Third Ave Ste C11

Chula Vista, CA 91910

(619) 426-0841

Provider ID: 254942

License: AU2646

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Herrera, Charity MA

310 Third Ave Ste C11

Chula Vista, CA 91910

(619) 426-0841

Provider ID: 253423

License: AU2110

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 337

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Cultural Competency: NR 801 Orange Ave Ste 205 office to discuss their

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

CORONADO

92118

Alvira, Providence MA

801 Orange Ave Ste 205

Coronado, CA 92118

(619) 437-8154

Provider ID: 254554

License: AU1745

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Alvira, Providence MA

Coronado, CA 92118

(619) 437-8154

Provider ID: 254554

License: HA3591

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Crawford, Joyce MS

801 Orange Ave Ste 205

Coronado, CA 92118

(619) 437-8154

Provider ID: 254943

License: AU2646

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Herrera, Charity MA

801 Orange Ave Ste 205

Coronado, CA 92118

(619) 437-8154

Provider ID: 253424

License: AU2110

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

EL CAJON

92021

Alvira, Providence MA

1767 E Main St

El Cajon, CA 92021

(619) 440-6516

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 338

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Provider ID: 254555 accessibility indicators are not Hours: M-SA 9AM-5PM

License: HA3591 present. PTA: No

Credentials and/or board Cultural Competency: NR

certification: No Accessibility: B; Members

Accepting New Members: Yes Crawford, Joyce MS should call the provider’s

Hours: M-SA 9AM-5PM 1767 E Main St office to discuss their

PTA: No El Cajon, CA 92021 accessibility needs when there

Cultural Competency: NR (619) 440-6516 is limited access or when

Accessibility: B; Members Provider ID: 254941 accessibility indicators are not

should call the provider’s License: AU2646 present.

office to discuss their Credentials and/or board

accessibility needs when there certification: No

is limited access or when Accepting New Members: Yes Shasky, Gary MA

accessibility indicators are not Hours: M-SA 9AM-5PM 1767 E Main St

present. PTA: No El Cajon, CA 92021

Cultural Competency: NR (619) 440-6516

Accessibility: B; Members Provider ID: 253262

Alvira, Providence MA should call the provider’s License: AU1361

1767 E Main St office to discuss their Credentials and/or board

El Cajon, CA 92021 accessibility needs when there certification: No

(619) 440-6516 is limited access or when Accepting New Members: Yes

Provider ID: 254555 accessibility indicators are not Hours: M-SA 9AM-5PM

License: AU1745 present. PTA: No

Credentials and/or board Cultural Competency: NR

certification: No Accessibility: B; Members

Accepting New Members: Yes Herrera, Charity MA should call the provider’s

Hours: M-SA 9AM-5PM 1767 E Main St office to discuss their

PTA: No El Cajon, CA 92021 accessibility needs when there

Cultural Competency: NR (619) 440-6516 is limited access or when

Accessibility: B; Members Provider ID: 253422 accessibility indicators are not

should call the provider’s License: AU2110 present.

office to discuss their Credentials and/or board

accessibility needs when there certification: No ESCONDIDO is limited access or when Accepting New Members: Yes

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 339

Page 362: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

92025

Alvira, Providence MA

330 W Felicita Ave Ste A4

Escondido, CA 92025

(760) 489-1323

Provider ID: 254552

License: HA3591

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Alvira, Providence MA

330 W Felicita Ave Ste A4

Escondido, CA 92025

(760) 489-1323

Provider ID: 254552

License: AU1745

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Herrera, Charity MA

330 W Felicita Ave Ste A4

Escondido, CA 92025

(760) 489-1323

Provider ID: 253417

License: AU2110

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA MESA

91942

Alvira, Providence MA

5565 Grossmont Center Dr Ste

463

La Mesa, CA 91942

(619) 589-5414

Provider ID: 254559

License: AU1745

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Alvira, Providence MA

5565 Grossmont Center Dr Ste

463

La Mesa, CA 91942

(619) 589-5414

Provider ID: 254559

License: HA3591

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 340

Page 363: 2021 Direktoryo ng Provider at Parmasya Blue Shield

463

SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Crawford, Joyce MS

5565 Grossmont Center Dr Ste

La Mesa, CA 91942

(619) 589-5414

Provider ID: 254940

License: AU2646

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Herrera, Charity MA

5565 Grossmont Center Dr

La Mesa, CA 91942

(619) 589-5414

Provider ID: 253418

License: AU2110

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Herrera, Charity MA

5565 Grossmont Center Dr Ste

463 Bldg 3

La Mesa, CA 91942

(619) 589-5414

Provider ID: 253427

License: AU2110

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92120

Alvira, Providence MA

6367 Alvarado Ct Ste 101

San Diego, CA 92120

(619) 583-7002

Provider ID: 254551

License: HA3591

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Alvira, Providence MA

6367 Alvarado Ct Ste 101

San Diego, CA 92120

(619) 583-7002

Provider ID: 254551

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 341

Page 364: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

License: AU1745

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Crawford, Joyce MS

6367 Alvarado Ct Ste 101

San Diego, CA 92120

(619) 583-7002

Provider ID: 254944

License: AU2646

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present. Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Herrera, Charity MA

6367 Alvarado Ct Ste 101

San Diego, CA 92120

(619) 583-7002

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

Provider ID: 253425

License: AU2110

accessibility needs when there

is limited access or when

Credentials and/or board accessibility indicators are not

certification: No

Accepting New Members: Yes

present.

Hours: M-SA 9AM-5PM

PTA: No Alvira, Providence MA

Cultural Competency: NR 9340 Clairemont Mesa Blvd Ste

Accessibility: B; Members D

should call the provider’s

office to discuss their

accessibility needs when there

San Diego, CA 92123

(858) 278-9911

Provider ID: 254556

is limited access or when License: AU1745

accessibility indicators are not

present.

Credentials and/or board

certification: No

92123

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Alvira, Providence MA

9340 Clairemont Mesa Blvd Ste

D

San Diego, CA 92123

(858) 278-9911

Provider ID: 254556

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

License: HA3591

Credentials and/or board

certification: No

accessibility indicators are not

present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 342

Page 365: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Crawford, Joyce MS

9340 Clairemont Mesa Blvd Ste

D

San Diego, CA 92123

(858) 278-9911

Provider ID: 254938

License: AU2646

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Herrera, Charity MA

9340 Clairemont Mesa Blvd Ste

D

San Diego, CA 92123

(858) 278-9911

Provider ID: 253420

License: AU2110

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Shasky, Gary MA

9340 Clairemont Mesa Blvd Ste

D

San Diego, CA 92123

(858) 278-9911

Provider ID: 253263

License: AU1361

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SOLANA BEACH

92075

Alvira, Providence MA

740 Lomas Santa Fe Dr Ste 110

Solana Beach, CA 92075

(858) 259-4182

Provider ID: 254557

License: AU1745

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Alvira, Providence MA

740 Lomas Santa Fe Dr Ste 110

Solana Beach, CA 92075

(858) 259-4182

Provider ID: 254557

License: HA3591

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 343

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Crawford, Joyce MS

740 Lomas Santa Fe Dr Ste 110

Solana Beach, CA 92075

(858) 259-4182

Provider ID: 254939

License: AU2646

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Herrera, Charity MA

740 Lomas Santa Fe Dr

Solana Beach, CA 92075

(858) 259-4182

Provider ID: 253419

License: AU2110

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Cardiac Electrophysiology

ENCINITAS

92024

Hamzei, Ali MD

320 Santa Fe Dr Ste 204

Encinitas, CA 92024

(760) 944-7300

Provider ID: 272339

License: A62682

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Farsi

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA JOLLA

92037

Hamzei, Ali MD

9850 Genesee Ave Ste 780

La Jolla, CA 92037

(858) 824-2900

Provider ID: 272340

License: A62682

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 344

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Whitwam, Wayne MD

9850 Genesee Ave Ste 780

La Jolla, CA 92037

(858) 450-3388

Provider ID: 65744

License: A90625

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Cardiology

CHULA VISTA

91910

Aizin, Vitali MD

321 E St Ste A

Chula Vista, CA 91910

(619) 934-3260

Provider ID: 103813

License: A82761

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Russian,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Berman, Brett MD

321 E St Ste A

Chula Vista, CA 91910

(619) 934-3260

Provider ID: 35528

License: A78854

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

91911

Pugh, Matthew DO

754 Medical Center Ct Ste 206

Chula Vista, CA 91911

(619) 482-4333

Provider ID: 265215

License: 20A12102

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

EL CAJON

92020

Kafri, Hassan MD

328 Highland Ave Ste 200

El Cajon, CA 92020

(619) 930-9404

Provider ID: 240321

License: A96002

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 345

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Farsi, German, Russian,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Zavaro, Suhail MD

300 S Pierce St # 102

El Cajon, CA 92020

(619) 668-4700

Provider ID: 241921

License: A46162

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Arabic,

Spanish, Tagalog

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA JOLLA

92037

Cohen, David MD

9850 Genesee Ave Ste 940

La Jolla, CA 92037

(858) 658-0020

Provider ID: 127778

License: A110351

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

NATIONAL CITY

91950

Pandhi, Jay MD

655 Euclid Ave Ste 208

National City, CA 91950

(619) 512-1915

Provider ID: 269088

License: C56015

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Cardiovascular Disease

CHULA VISTA

91910

Kafri, Hassan MD

429 Broadway

Chula Vista, CA 91910

(619) 434-0204

Provider ID: 259905

License: A96002

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 346

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

PTA: No

Other Language: Arabic,

Farsi, German, Russian,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

91911

Moussavian, Mehran DO

765 Medical Center Ct Ste 211

Chula Vista, CA 91911

(619) 616-2100

Provider ID: 238395

License: 20A7241

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Rough, Steven MD

750 Medical Center Ct Ste 3

Chula Vista, CA 91911

(619) 434-4288

Provider ID: 275470

License: A124001

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Shetabi, Kambiz MD

765 Medical Center Ct Ste 211

Chula Vista, CA 91911

(619) 616-2100

Provider ID: 257163

License: A126187

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

91914

Cepin, Daniel MD

890 Eastlake Pkwy Ste 205

Chula Vista, CA 91914

(619) 482-0300

Provider ID: 276989

License: G52521

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 347

Page 370: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

present. PTA: No present.

Gordon, John MD

890 Eastlake Pkwy Ste 203

Chula Vista, CA 91914

(858) 244-6800

Provider ID: 278285

License: C42631

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Mehta, Hirsch MD

890 Eastlake Pkwy Ste 205

Chula Vista, CA 91914

(858) 244-6800

Provider ID: 275526

License: A105910

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

EL CAJON

92020

Hourani, Rayan MD

300 S Pierce St # 102

El Cajon, CA 92020

(619) 668-4700

Provider ID: 241994

License: A119614

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Farsi, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

92021

Moussavian, Mehran DO

1625 E Main St Ste 201

El Cajon, CA 92021

(619) 486-6512

Provider ID: 248176

License: 20A7241

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Shetabi, Kambiz MD

1625 E Main St Ste 201

El Cajon, CA 92021

(619) 486-6512

Provider ID: 278855

License: A126187

Credentials and/or board

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 348

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ENCINITAS

92024

Avalos, Roy MD

320 Santa Fe Dr Ste 204

Encinitas, CA 92024

(760) 944-7300

Provider ID: 257178

License: A68893

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Backman, John MD

320 Santa Fe Dr Ste 204

Encinitas, CA 92024

(760) 944-7300

Provider ID: 265195

License: G29156

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Jacoby, Richard MD

700 Garden View Ct Ste 204

Encinitas, CA 92024

(760) 452-6334

Provider ID: 257039

License: G161416

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Kulhanek, Jan MD

320 Santa Fe Dr Ste 204

Encinitas, CA 92024

(760) 944-7300

Provider ID: 265265

License: A102299

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Czech

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 349

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Mcginty, Patrick MD

320 Santa Fe Dr Ste 204

Encinitas, CA 92024

(760) 944-7300

Provider ID: 265220

License: A94682

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Mehboob, Salman MD

700 Garden View Ct Ste 204

Encinitas, CA 92024

(760) 452-6334

Provider ID: 257032

License: A119955

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Urdu

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Rasch, Damian DO

320 Santa Fe Dr Ste 204

Encinitas, CA 92024

(760) 944-7300

Provider ID: 265224

License: 20A14015

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ESCONDIDO

92025

Moussavian, Mehran DO

488 E Valley Pkwy Ste 107

Escondido, CA 92025

(760) 294-0480

Provider ID: 278815

License: 20A7241

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Shetabi, Kambiz MD

488 E Valley Pkwy Ste 107

Escondido, CA 92025

(760) 294-0480

Provider ID: 278853

License: A126187

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 350

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA JOLLA

92037

Avalos, Roy MD

9850 Genesee Ave Ste 780

La Jolla, CA 92037

(858) 824-2900

Provider ID: 272508

License: A68893

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Costello, Dennis MD

9850 Genesee Ave Ste 430

La Jolla, CA 92037

(858) 450-3388

Provider ID: 259911

License: G33998

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Mendenhall, George MD

9850 Genesee Ave Ste 940

La Jolla, CA 92037

(858) 658-0020

Provider ID: 127795

License: C152874

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Russo, Robert MD

9850 Genesee Ave Ste 350

La Jolla, CA 92037

(858) 886-7595

Provider ID: 105088

License: G62682

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA MESA

91942

Azimi, Nassir MD

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 351

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

5565 Grossmont Center Dr Ste

3 Ste 444

La Mesa, CA 91942

(619) 784-1060

Provider ID: 259741

License: A91478

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Mehranpour, Payam MD

8851 Center Dr Ste 405

La Mesa, CA 91942

(619) 377-6262

Provider ID: 252973

License: A112670

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Farsi, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

NATIONAL CITY

91950

Kim, James MD

502 Euclid Ave Ste 104

National City, CA 91950

(619) 434-4288

Provider ID: 275402

License: A121180

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Korean,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Ly, Nancy MD

502 Euclid Ave Ste 104

National City, CA 91950

(619) 434-4288

Provider ID: 275480

License: A125595

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Nanavati, Vimal MD

2345 E 8th St Ste 111

National City, CA 91950

(619) 585-0476

Provider ID: 270830

License: G83522

Credentials and/or board

certification: No

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 352

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Oviedo-linares, Raul MD

502 Euclid Ave Ste 104

National City, CA 91950

(619) 434-4288

Provider ID: 275482

License: A76050

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Polish,

Spanish, Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Rough, Steven MD

502 Euclid Ave Ste 104

National City, CA 91950

(619) 434-4288

Provider ID: 275469

License: A124001

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Wysoczanski, Mariusz MD

502 Euclid Ave Ste 104

National City, CA 91950

(619) 434-4288

Provider ID: 275513

License: C55986

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Polish,

Spanish, Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

POWAY

92064

Nanavati, Vimal MD

15706 Pomerado Rd Ste 104

Poway, CA 92064

(619) 585-0476

Provider ID: 268058

License: G83522

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 353

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

SAN DIEGO

92103

Glassman, Jerrold MD

4060 4th Ave Ste 650

San Diego, CA 92103

(619) 819-7222

Provider ID: 246319

License: G34309

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Keramati, Shahin MD

501 Washington St Ste 512

San Diego, CA 92103

(619) 297-0014

Provider ID: 53717

License: G80033

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Farsi

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Mai, Tuan MD

501 Washington St Ste 512

San Diego, CA 92103

(619) 297-0014

Provider ID: 265367

License: A113870

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Salami, Bobak MD

501 Washington St Ste 512

San Diego, CA 92103

(619) 297-0014

Provider ID: 265353

License: A75049

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92105

Ly, Nancy MD

4844 University Ave Ste A

San Diego, CA 92105

(619) 434-4288

Provider ID: 275481

License: A125595

Credentials and/or board

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 354

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92111

Nguyen, Tri MD

7345 Linda Vista Rd Ste A

San Diego, CA 92111

(858) 277-5463

Provider ID: 269955

License: G79496

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Chinese,

Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there License: 20A7241

is limited access or when

accessibility indicators are not

Credentials and/or board

certification: No

present. Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Sclar, Craig MD

7830 Clairemont Mesa Blvd Ste

100

San Diego, CA 92111

(858) 268-1111

Provider ID: 43642

Other Language: Farsi,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

License: A36023

Credentials and/or board

accessibility needs when there

is limited access or when

certification: No accessibility indicators are not

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

present.

PTA: Yes

Cultural Competency: NR Shetabi, Kambiz MD

Accessibility: B, W; Members 292 Euclid Ave Ste 210

should call the provider’s

office to discuss their

accessibility needs when there

San Diego, CA 92114

(619) 616-2100

Provider ID: 257164

is limited access or when License: A126187

accessibility indicators are not

present.

Credentials and/or board

certification: No

92114

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Moussavian, Mehran DO

292 Euclid Ave Ste 210

San Diego, CA 92114

(619) 616-2100

Provider ID: 238396

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 355

Page 378: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

accessibility needs when there Provider ID: 276846 office to discuss their

is limited access or when

accessibility indicators are not

present.

92115

Nguyen, Tri MD

4206 44th St

San Diego, CA 92115

(361) 962-4943

Provider ID: 269954

License: G79496

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Chinese,

Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Sherev, Dimitri MD

6402 El Cajon Blvd Ste 102

San Diego, CA 92115

(619) 582-4490

License: A70917

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Bulgarian,

Malayalam, Russian, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92120

Nanavati, Vimal MD

6655 Alvarado Rd

San Diego, CA 92120

(619) 229-3170

Provider ID: 268056

License: G83522

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92123

Gordon, John MD

3131 Berger Ave Ste 200

San Diego, CA 92123

(858) 244-6800

Provider ID: 278284

License: C42631

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Mehta, Hirsch MD

3131 Berger Ave Ste 200

San Diego, CA 92123

(858) 244-6800

Provider ID: 275525

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 356

Page 379: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

License: A105910

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92127

Moussavian, Mehran DO

16918 Dove Canyon Rd Ste

103

San Diego, CA 92127

(858) 649-5100

Provider ID: 265302

License: 20A7241

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN MARCOS

92078

Moussavian, Mehran DO

955 Boardwalk Ste 100

San Marcos, CA 92078

(619) 616-2100

Provider ID: 238397

License: 20A7241

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Shetabi, Kambiz MD

955 Boardwalk Ste 100

San Marcos, CA 92078

(760) 798-8855

Provider ID: 278854

License: A126187

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN YSIDRO

92173

Aizin, Vitali MD

4630 Border Village Rd Ste H

San Ysidro, CA 92173

(619) 428-3780

Provider ID: 254961

License: A82761

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 357

Page 380: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Other Language: Russian,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

VISTA

92083

Bui, Hanh MD

2067 W Vista Way Ste 225

Vista, CA 92083

(760) 630-2550

Provider ID: 259728

License: A79185

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Chinese,

Spanish, Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Holland, Marian MD

2067 W Vista Way Ste 225

Vista, CA 92083

(760) 630-2550

Provider ID: 276890

License: A100523

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Certified Acupuncturist

CHULA VISTA

91910

Wilcox, Wenonah LAC

786 Third Ave Ste B

Chula Vista, CA 91910

(619) 425-0797

Provider ID: 265547

License: AC13675

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Certified Nurse Practitioner

CAMPO

91906

Hurley, Teresa NP

1388 Buckman Springs Rd

Campo, CA 91906

(619) 662-4100

Provider ID: 265473

License: NP95012693

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 358

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

CARLSBAD

92009

Halpern, David NP

Contract terminated as of

7/31/2021

1905 Calle Barcelona Ste 211

Carlsbad, CA 92009

(858) 799-0933

Provider ID: 275643

License: NP95008040

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92011

Batac, Nadine NP

6010 Hidden Valley Rd Ste 110

Carlsbad, CA 92011

(858) 432-7880

Provider ID: 254563

License: NP21763

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Bierman, Andrew NP

6010 Hidden Valley Rd Ste 200

Carlsbad, CA 92011

(760) 631-3000

Provider ID: 252271

License: NP95011909

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Bishop, Leslie NP

6010 Hidden Valley Rd Ste 200

Carlsbad, CA 92011

(760) 631-3000

Provider ID: 252886

License: NP95010047

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Binavi, Hownaz NP

6010 Hidden Valley Rd Ste 120

Carlsbad, CA 92011

(760) 884-5990

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 359

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Provider ID: 272946

License: NP95010956

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Kurdish,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Hooper, Bonnie NP

6010 Hidden Valley Rd Ste 120

Carlsbad, CA 92011

(760) 884-5990

Provider ID: 269842

License: NP6495

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

CHULA VISTA

91910

Carapia, Fabiola NP

340 4th Ave Ste 4

Chula Vista, CA 91910

(619) 427-1144

Provider ID: 214090

License: NP20855

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Carapia, Fabiola NP

340 4th Ave Ste 4

Chula Vista, CA 91910

(619) 427-1144

Provider ID: 214090

License: RN603937

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Collinsworth, Jessica NP

344 F St Ste 203

Chula Vista, CA 91910

(619) 427-9627

Provider ID: 259725

License: NP95008585

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 360

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

present. PTA: No 880 3rd Ave Ste A

Lopez, Rito NP

340 Fourth Ave Ste 10

Chula Vista, CA 91910

(619) 934-2215

Provider ID: 258168

License: NP95013287

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Spaulding, Enjoli NP

786 Third Ave Ste B

Chula Vista, CA 91910

(619) 425-0797

Provider ID: 265022

License: NP21947

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

Cultural Competency: NR Chula Vista, CA 91911

Accessibility: B; Members (619) 662-4100

should call the provider’s Provider ID: 275530

office to discuss their License: NP95000200

accessibility needs when there Credentials and/or board

is limited access or when certification: No

accessibility indicators are not Accepting New Members: Yes

present. Hours: M-SA 9AM-5PM

PTA: No

91911 Cultural Competency: NR

Accessibility: B; Members

Akins, Melanie NP should call the provider’s

752 Medical Center Ct Ste 302 office to discuss their

Chula Vista, CA 91911 accessibility needs when there

(619) 421-3361 is limited access or when

Provider ID: 214065 accessibility indicators are not

License: NP95008069 present.

Credentials and/or board

certification: No

Accepting New Members: Yes Lang, Po NP

Hours: M-SA 9AM-5PM 765 Medical Center Ct Ste 210

PTA: No Chula Vista, CA 91911

Cultural Competency: NR (619) 482-0565

Accessibility: B; Members Provider ID: 278437

should call the provider’s License: NP95016187

office to discuss their Credentials and/or board

accessibility needs when there certification: No

is limited access or when Accepting New Members: Yes

accessibility indicators are not Hours: M-SA 9AM-5PM

present. PTA: No

Cultural Competency: NR

Accessibility: B; Members

Da Cunha, Maria Luisa NP should call the provider’s

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 361

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Ponce, Sarah NP

1058 Third Ave

Chula Vista, CA 91911

(619) 662-4100

Provider ID: 265544

License: NP95005787

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

EL CAJON

92021

Luckett, De Courcy NP

1580 N 2nd St

El Cajon, CA 92021

(619) 447-2425

Provider ID: 259740

License: NP95000435

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Pham, Mary-lysianne NP

1351 Broadway

El Cajon, CA 92021

(619) 383-6703

Provider ID: 276921

License: NP95008968

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Sirleaf, Massanu NP

1351 Broadway

El Cajon, CA 92021

(619) 383-6703

Provider ID: 275458

License: NP95000692

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ENCINITAS

92024

Buckley, Patricia NP

326 Santa Fe Dr Ste 105

Encinitas, CA 92024

(760) 452-3340

Provider ID: 279060

License: NP95015705

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 362

Page 385: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Binavi, Hownaz NP

477 N El Camino Real Ste D308

Encinitas, CA 92024

(760) 436-2300

Provider ID: 272947

License: NP95010956

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Kurdish,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Coyle, Jennifer NP

326 Santa Fe Dr Ste 105

Encinitas, CA 92024

(760) 452-3340

Provider ID: 279276

License: NP95006591

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Herr, Colleen NP

477 N El Camino Real Ste A308

Encinitas, CA 92024

(760) 436-8881

Provider ID: 269056

License: NP11633

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Hooper, Bonnie NP

477 N El Camino Real Ste D308

Encinitas, CA 92024

(760) 436-2300

Provider ID: 269843

License: NP6495

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Huynh, Melvyn NP

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 363

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

662 Encinitas Blvd Ste 220 office to discuss their License: NP95009642

Encinitas, CA 92024 accessibility needs when there Credentials and/or board

(833) 446-6363 is limited access or when certification: No

Provider ID: 271794 accessibility indicators are not Accepting New Members: Yes

License: NP95002765 present. Hours: M-SA 9AM-5PM

Credentials and/or board PTA: No

certification: No Cultural Competency: NR

Accepting New Members: Yes Nizheborsky, Oksana NP Accessibility: B; Members

Hours: M-SA 9AM-5PM 320 Santa Fe Dr Ste 107c should call the provider’s

PTA: No Encinitas, CA 92024 office to discuss their

Cultural Competency: NR (760) 230-8994 accessibility needs when there

Accessibility: B; Members Provider ID: 259621 is limited access or when

should call the provider’s License: NP95001042 accessibility indicators are not

office to discuss their Credentials and/or board present.

accessibility needs when there certification: No

is limited access or when Accepting New Members: Yes

accessibility indicators are not Hours: M-SA 9AM-5PM Pidding, Apryl NP

present. PTA: No 700 Garden View Ct Ste 102

Other Language: Russian Encinitas, CA 92024

Cultural Competency: NR (760) 783-0441

Myers, Jesse NP Accessibility: B; Members Provider ID: 265372

477 N El Camino Real Ste A308 should call the provider’s License: NP20027

Encinitas, CA 92024 office to discuss their Credentials and/or board

(760) 436-8881 accessibility needs when there certification: No

Provider ID: 271841 is limited access or when Accepting New Members: Yes

License: NP18224 accessibility indicators are not Hours: M-SA 9AM-5PM

Credentials and/or board present. PTA: No

certification: No Cultural Competency: NR

Accepting New Members: Yes Accessibility: B; Members

Hours: M-SA 9AM-5PM Nyagaya, Linda NP should call the provider’s

PTA: No 662 Encinitas Blvd Ste 220 office to discuss their

Cultural Competency: NR Encinitas, CA 92024 accessibility needs when there

Accessibility: B; Members (833) 446-6363 is limited access or when

should call the provider’s Provider ID: 271805 accessibility indicators are not

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 364

Page 387: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

present.

Reppenhagen, Denise NP

634 Hollyridge Dr

Encinitas, CA 92024

(619) 662-4100

Provider ID: 269845

License: NP19213

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Tawfilis, Amy NP

320 Santa Fe Dr Ste 108

Encinitas, CA 92024

(760) 436-4558

Provider ID: 275702

License: NP95013902

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Woodruff, Whitney NP

700 Garden View Ct Ste 102

Encinitas, CA 92024

(760) 783-0441

Provider ID: 265260

License: NP16535

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ESCONDIDO

92025

Konyn, Catherine NPF

1001 E Grand Ave

Escondido, CA 92025

(760) 520-8200

Provider ID: 246834

License: NP19095

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Spaulding, Enjoli NP

631 E Grand Ave

Escondido, CA 92025

(760) 294-1660

Provider ID: 242014

License: NP21947

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 365

Page 388: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92029

Batac, Nadine NP

1340 W Valley Pkwy Ste 201

Escondido, CA 92029

(619) 325-1161

Provider ID: 268445

License: NP21763

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Bishop, Leslie NP

1955 Citracado Pkwy Ste 102

Escondido, CA 92029

(760) 630-3000

Provider ID: 277680

License: NP95010047

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

FALLBROOK

92028

Berrios, Alvaro NPF

593 E Elder St Ste B

Fallbrook, CA 92028

(760) 723-5900

Provider ID: 245684

License: NP16355

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA JOLLA

92037

Buckley, Patricia NP

9850 Genesee Ave Ste 560

La Jolla, CA 92037

(858) 552-1410

Provider ID: 279062

License: NP95015705

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Goodman, Meagan NP

9850 Genesee Ave Ste 320

La Jolla, CA 92037

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 366

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

(858) 554-1212

Provider ID: 275825

License: NP95005125

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Goshen, Kirsten NP

9850 Genesee Ave Ste 570

La Jolla, CA 92037

(858) 457-4917

Provider ID: 257188

License: NP95005769

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Halpern, David NP

Contract terminated as of

7/31/2021

9850 Genesee Ave Ste 320

La Jolla, CA 92037

(858) 554-1212

Provider ID: 275642

License: NP95008040

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Kovaleski, Natalia PA

Contract terminated as of

6/30/2021

9850 Genesee Ave Ste 320

La Jolla, CA 92037

(858) 554-1212

Provider ID: 269523

License: PA22994

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Silvestri, Nicole NP

Contract terminated as of

7/31/2021

9850 Genesee Ave Ste 320

La Jolla, CA 92037

(858) 554-1212

Provider ID: 278688

License: NP95010137

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 367

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

accessibility needs when there certification: No

is limited access or when Accepting New Members: Yes

accessibility indicators are not Hours: M-SA 9AM-5PM Vierra, Erin NP

present. PTA: No Contract terminated as of

Other Language: Vietnamese 7/31/2021

Cultural Competency: NR 9850 Genesee Ave Ste 320

Tawfilis, Amy NP Accessibility: B; Members La Jolla, CA 92037

9850 Genesee Ave Ste 440 should call the provider’s (858) 554-1212

La Jolla, CA 92037 office to discuss their Provider ID: 278693

(858) 453-5944 accessibility needs when there License: NP95006057

Provider ID: 275701 is limited access or when Credentials and/or board

License: NP95013902 accessibility indicators are not certification: No

Credentials and/or board present. Accepting New Members: No

certification: No Hours: M-SA 9AM-5PM

Accepting New Members: Yes PTA: No

Hours: M-SA 9AM-5PM Tomicich, Stephanie NP Cultural Competency: NR

PTA: No 9850 Genesee Ave Ste 440 Accessibility: B; Members

Cultural Competency: NR La Jolla, CA 92037 should call the provider’s

Accessibility: B; Members (858) 453-5944 office to discuss their

should call the provider’s Provider ID: 275677 accessibility needs when there

office to discuss their License: NP95002402 is limited access or when

accessibility needs when there Credentials and/or board accessibility indicators are not

is limited access or when certification: No present.

accessibility indicators are not Accepting New Members: Yes

present. Hours: M-SA 9AM-5PM

PTA: No Weidner, Anne NP

Cultural Competency: NR Contract terminated as of

Tran, Daphne NP Accessibility: B; Members 7/31/2021

9850 Genesee Ave Ste 900 should call the provider’s 9850 Genesee Ave Ste 320

La Jolla, CA 92037 office to discuss their La Jolla, CA 92037

(858) 452-1279 accessibility needs when there (858) 554-1212

Provider ID: 265396 is limited access or when Provider ID: 278687

License: NP95011984 accessibility indicators are not License: NP95009793

Credentials and/or board present. Credentials and/or board

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 368

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

certification: No certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Yartseva, Yuliya NP

7855 Ivanhoe Ave Ste 101

La Jolla, CA 92037

(858) 554-1212

Provider ID: 213716

License: NP95007558

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Zuniga, Vania NP

Contract terminated as of

7/31/2021

9850 Genesee Ave Ste 320

La Jolla, CA 92037

(858) 554-1212

Provider ID: 278674

License: NP95007433

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Chinese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA MESA

91942

Loyola, Mary Ann NP

8851 Center Dr Ste 505

La Mesa, CA 91942

(619) 461-3880

Provider ID: 244503

License: NP95011408

Credentials and/or board

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Roh, Dongyon NP

5360 Jackson Dr Ste 100

La Mesa, CA 91942

(619) 713-6514

Provider ID: 259623

License: NP95004887

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Korean

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 369

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

present.

Thomas, Shorena NP

Contract terminated as of

6/30/2021

7339 El Cajon Blvd Ste I

La Mesa, CA 91942

(619) 698-0606

Provider ID: 208940

License: NP95006664

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Polish,

Russian

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

NATIONAL CITY

91950

Alcantar, Jose NP

655 Euclid Ave Ste 304

National City, CA 91950

(619) 470-7700

Provider ID: 278776

License: NP95003735

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Villanueva De Gutie, Berenice

NP

217 Highland Ave

National City, CA 91950

(619) 434-7308

Provider ID: 279151

License: NP95002188

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

OCEANSIDE

92056

Andolina, Sara NP

3923 Waring Rd Ste A

Oceanside, CA 92056

(760) 724-8782

Provider ID: 259767

License: NP95000358

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Quinn, Erin NP

3998 Vista Way Ste C

Oceanside, CA 92056

(760) 941-1440

Provider ID: 279103

License: NP6812

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 370

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

POWAY

92064

Bishop, Leslie NP

15611 Pomerado Rd Ste 505

Poway, CA 92064

(760) 631-3000

Provider ID: 252887

License: NP95010047

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Travers, Naomi NP

15725 Pomerado Rd Ste 102

Poway, CA 92064

(858) 397-5755

Provider ID: 242463

License: NP12905

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92102

Feizi, Sedi NP

995 Gateway Center Way Ste

207

San Diego, CA 92102

(619) 263-9729

Provider ID: 252958

License: NP95002309

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92103

Binavi, Hownaz NP

4060 4th Ave Ste 415

San Diego, CA 92103

(619) 298-9809

Provider ID: 256105

License: NP95010956

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Kurdish,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 371

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Dwyer, Erin NP

4060 4th Ave Ste 310

San Diego, CA 92103

(619) 297-4707

Provider ID: 265299

License: NP95004184

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Jersey, Karen NP

3969 4th Ave Ste 208

San Diego, CA 92103

(619) 848-5777

Provider ID: 259055

License: NP21684

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Medilo, Lovella NP

4033 3rd Ave Ste 430

San Diego, CA 92103

(619) 578-3740

Provider ID: 273463

License: NP95010904

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Thomas, Shorena NP

Contract terminated as of

6/30/2021

4060 4th Ave Ste 220

San Diego, CA 92103

(619) 299-2350

Provider ID: 265394

License: NP95006664

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Polish,

Russian

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92105

Villanueva De Gutie, Berenice

NP

4060 Fairmount Ave

San Diego, CA 92105

(619) 255-9155

Provider ID: 279150

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 372

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

License: NP95002188 is limited access or when certification: No

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92108

Batac, Nadine NP

7525 Metropolitan Dr Ste 302

San Diego, CA 92108

(619) 761-5308

Provider ID: 254564

License: NP21763

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

accessibility indicators are not

present.

92114

Gordon, Danielle NP

292 Euclid Ave Ste 210

San Diego, CA 92114

(619) 662-4100

Provider ID: 269847

License: NP95010963

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92117

Case, Erinn NP

3737 Moraga Ave Ste B103

San Diego, CA 92117

(858) 554-1212

Provider ID: 269644

License: NP95009488

Credentials and/or board

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Yartseva, Yuliya NP

3737 Moraga Ave Ste B103

San Diego, CA 92117

(858) 554-1212

Provider ID: 213715

License: NP95007558

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 373

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

PTA: No92121 Other Language: Kurdish, Quiceno, Michael NP

Bosley, Jazmyne NP Spanish 10251 Vista Sorrento Pkwy Ste

10251 Vista Sorrento Pkwy Ste Cultural Competency: NR 280

280 Accessibility: B; Members San Diego, CA 92121

San Diego, CA 92121 should call the provider’s (818) 575-6351

(818) 575-6351 office to discuss their Provider ID: 279964

Provider ID: 279141 accessibility needs when there License: NP95011137

License: NP95010166 is limited access or when Credentials and/or board

Credentials and/or board accessibility indicators are not certification: No

certification: No present. Accepting New Members: Yes

Accepting New Members: Yes Hours: M-SA 9AM-5PM

Hours: M-SA 9AM-5PM PTA: No

PTA: No Pantoja, Danica-ella NP Other Language: Spanish

Cultural Competency: NR 10251 Vista Sorrento Pkwy Ste Cultural Competency: NR

Accessibility: B; Members 280 Accessibility: B; Members

should call the provider’s San Diego, CA 92121 should call the provider’s

office to discuss their (818) 575-6351 office to discuss their

accessibility needs when there Provider ID: 279148 accessibility needs when there

is limited access or when License: NP95016725 is limited access or when

accessibility indicators are not Credentials and/or board accessibility indicators are not

present. certification: No present.

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

Binavi, Hownaz NP PTA: No Shatswell, Brenna NP

9339 Genesee Ave Ste 350 Cultural Competency: NR 10251 Vista Sorrento Pkwy Ste

San Diego, CA 92121 Accessibility: B; Members 280

(858) 454-4300 should call the provider’s San Diego, CA 92121

Provider ID: 256104 office to discuss their (818) 575-6351

License: NP95010956 accessibility needs when there Provider ID: 279957

Credentials and/or board is limited access or when License: NP95009161

certification: No accessibility indicators are not Credentials and/or board

Accepting New Members: Yes present. certification: No

Hours: M-SA 9AM-5PM Accepting New Members: Yes

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 374

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92123

Camargo-lowthers, Angelica

CNP

8010 Frost St Ste 510

San Diego, CA 92123

(858) 637-4700

Provider ID: 241988

License: RN521048

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Camargo-lowthers, Angelica

CNP

8010 Frost St Ste 510

San Diego, CA 92123

(858) 637-4700

Provider ID: 241988

License: NP14412

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Collinsworth, Jessica NP

5395 Ruffin Rd Ste 204

San Diego, CA 92123

(858) 571-3630

Provider ID: 259724

License: NP95008585

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Mcgilloway, Melanie NP

3444 Kearny Villa Rd Ste 202

San Diego, CA 92123

(858) 429-7646

Provider ID: 269731

License: NP95013799

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Roh, Dongyon NP

5395 Ruffin Rd Ste 204

San Diego, CA 92123

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 375

Page 398: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

(858) 571-3630

Provider ID: 259622

License: NP95004887

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Korean

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92127

Buckley, Patricia NP

16918 Dove Canyon Rd Ste

103

San Diego, CA 92127

(858) 649-5100

Provider ID: 279061

License: NP95015705

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92128

Moll, Jocelyn NP

11770 Bernardo Plaza Ct Ste

270

San Diego, CA 92128

(858) 485-0554

Provider ID: 276039

License: NP95010975

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92130

Kahl, Nicholas NP

12843 El Camino Real Ste 203

San Diego, CA 92130

(800) 926-8273

Provider ID: 269631

License: NP95006360

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Kovaleski, Natalia PA

Contract terminated as of

6/30/2021

12843 El Camino Real Ste 203

San Diego, CA 92130

(858) 554-1212

Provider ID: 269522

License: PA22994

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 376

Page 399: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN MARCOS

92069

Buckley, Patricia NP

838 Nordahl Rd Ste 300

San Marcos, CA 92069

(760) 748-8935

Provider ID: 279059

License: NP95015705

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Coyle, Jennifer NP

838 Nordahl Rd Ste 300

San Marcos, CA 92069

(760) 748-8935

Provider ID: 279275

License: NP95006591

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN YSIDRO

92173

Balingit, Kat NP

4004 Beyer Blvd

San Ysidro, CA 92173

(619) 662-4100

Provider ID: 265325

License: NP95012642

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Celiz, Adriana NP

3364 Beyer Blvd

San Ysidro, CA 92173

(619) 662-4100

Provider ID: 269473

License: NP95004315

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Ching, Leyda NP

3364 Beyer Blvd Ste 102

San Ysidro, CA 92173

(619) 600-4867

Provider ID: 276588

License: NP20123

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 377

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Credentials and/or board PTA: No

certification: No Other Language: Spanish

Accepting New Members: Yes Driscoll, Susan NP Cultural Competency: NR

Hours: M-SA 9AM-5PM 4004 Beyer Blvd Accessibility: B; Members

PTA: No San Ysidro, CA 92173 should call the provider’s

Cultural Competency: NR (619) 662-4100 office to discuss their

Accessibility: B; Members Provider ID: 269504 accessibility needs when there

should call the provider’s License: NP95012943 is limited access or when

office to discuss their Credentials and/or board accessibility indicators are not

accessibility needs when there certification: No present.

is limited access or when Accepting New Members: Yes

accessibility indicators are not Hours: M-SA 9AM-5PM

present. PTA: No Hacinas, Reynaldo NP

Other Language: Spanish 4004 Beyer Blvd

Cultural Competency: NR San Ysidro, CA 92173

Da Cunha, Maria Luisa NP Accessibility: B; Members (619) 662-4100

3364 Beyer Blvd Ste 102 should call the provider’s Provider ID: 269582

San Ysidro, CA 92173 office to discuss their License: NP95003024

(619) 662-4100 accessibility needs when there Credentials and/or board

Provider ID: 270251 is limited access or when certification: No

License: NP95000200 accessibility indicators are not Accepting New Members: Yes

Credentials and/or board present. Hours: M-SA 9AM-5PM

certification: No PTA: No

Accepting New Members: Yes Cultural Competency: NR

Hours: M-SA 9AM-5PM Duran, Rebecca NP Accessibility: B; Members

PTA: No 3364 Beyer Blvd Ste 103 should call the provider’s

Cultural Competency: NR San Ysidro, CA 92173 office to discuss their

Accessibility: B; Members (619) 662-4100 accessibility needs when there

should call the provider’s Provider ID: 269571 is limited access or when

office to discuss their License: NP21054 accessibility indicators are not

accessibility needs when there Credentials and/or board present.

is limited access or when certification: No

accessibility indicators are not Accepting New Members: Yes

present. Hours: M-SA 9AM-5PM Hurley, Teresa NP

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 378

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

4004 Beyer Blvd office to discuss their Credentials and/or board

San Ysidro, CA 92173 accessibility needs when there certification: No

(619) 662-4100 is limited access or when Accepting New Members: Yes

Provider ID: 253075 accessibility indicators are not Hours: M-SA 9AM-5PM

License: NP95012693 present. PTA: No

Credentials and/or board Other Language: Spanish

certification: No Cultural Competency: NR

Accepting New Members: Yes Lieber, Carol NP Accessibility: B; Members

Hours: M-SA 9AM-5PM 1601 Precision Park Ln should call the provider’s

PTA: No San Ysidro, CA 92173 office to discuss their

Cultural Competency: NR (619) 662-4100 accessibility needs when there

Accessibility: B; Members Provider ID: 253208 is limited access or when

should call the provider’s License: NP20849 accessibility indicators are not

office to discuss their Credentials and/or board present.

accessibility needs when there certification: No

is limited access or when Accepting New Members: Yes

accessibility indicators are not Hours: M-SA 9AM-5PM Nace, Michael NP

present. PTA: No 4004 Beyer Blvd

Cultural Competency: NR San Ysidro, CA 92173

Accessibility: B; Members (619) 662-4100

Lieber, Carol NP should call the provider’s Provider ID: 254731

4004 Beyer Blvd office to discuss their License: NP11492

San Ysidro, CA 92173 accessibility needs when there Credentials and/or board

(619) 662-4100 is limited access or when certification: No

Provider ID: 253207 accessibility indicators are not Accepting New Members: Yes

License: NP20849 present. Hours: M-SA 9AM-5PM

Credentials and/or board PTA: No

certification: No Cultural Competency: NR

Accepting New Members: Yes Martinez-sierra, Miguel NP Accessibility: B; Members

Hours: M-SA 9AM-5PM 3364 Beyer Blvd should call the provider’s

PTA: No San Ysidro, CA 92173 office to discuss their

Cultural Competency: NR (619) 662-4100 accessibility needs when there

Accessibility: B; Members Provider ID: 269472 is limited access or when

should call the provider’s License: NP95007913 accessibility indicators are not

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 379

Page 402: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

present. PTA: No Chatham, Olivia NP

Rivera Beltran, Heriberto NP

4004 Beyer Blvd

San Ysidro, CA 92173

(619) 662-4100

Provider ID: 269722

License: 95011671

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Sanders, Jessica NP

4004 Beyer Blvd

San Ysidro, CA 92173

(619) 662-4100

Provider ID: 253157

License: NP23004

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Shukla, Balwinder NP

3364 Beyer Blvd Ste 102

San Ysidro, CA 92173

(619) 662-4100

Provider ID: 276623

License: NP95015232

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

VISTA

92083

950 Civic Center Dr Ste A

Vista, CA 92083

(760) 439-4839

Provider ID: 279263

License: NP95009164

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Certified Registered Nurse

Anesthetist

ENCINITAS

92024

King, April CRNA

700 Garden View Ct Ste 102

Encinitas, CA 92024

(760) 783-0441

Provider ID: 271544

License: NA2595

Credentials and/or board

certification: No

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 380

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Certified Registered Nurse

Midwife

SAN DIEGO

92105

Strauss, Joanna E CRNM

4060 Fairmount Ave

San Diego, CA 92105

(619) 255-9155

Provider ID: 279162

License: NM1920

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Clinical Neuropsychologist

CARLSBAD

92011

Alasantro, Lori PhD

6010 Hidden Valley Rd Ste 200

Carlsbad, CA 92011

(760) 631-3000

Provider ID: 252909

License: PSY25817

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Quesnell, Tara DO

6010 Hidden Valley Rd Ste 200

Carlsbad, CA 92011

(760) 631-3000

Provider ID: 253082

License: 20A13609

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ESCONDIDO

92029

Quesnell, Tara DO

1955 Citracado Pkwy Ste 102

Escondido, CA 92029

(760) 631-3000

Provider ID: 253083

License: 20A13609

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 381

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA JOLLA

92037

Kaup, Allison PhD

9850 Genesee Ave Ste 530

La Jolla, CA 92037

(760) 631-3000

Provider ID: 276986

License: PSY26484

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

POWAY

92064

Kaup, Allison PhD

15611 Pomerado Rd Ste 505

Poway, CA 92064

(760) 631-3000

Provider ID: 253074

License: PSY26484

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Dermatology

Dermatopathology

SAN DIEGO

92121

Erickson, Christopher MD

6605 Nancy Ridge Dr

San Diego, CA 92121

(858) 750-2983

Provider ID: 213891

License: A109927

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Dermatology

CARLSBAD

92011

Brouha, Brook MD

6010 Hidden Valley Rd Ste 120

Carlsbad, CA 92011

(760) 884-5990

Provider ID: 272987

License: A97902

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: French

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 382

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

is limited access or when

accessibility indicators are not

present.

Special Expertise: HIV/AIDS

Riley, Jessica DO

6010 Hidden Valley Rd Ste 120

Carlsbad, CA 92011

(760) 884-5990

Provider ID: 265582

License: 20A16345

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

CHULA VISTA

91910

Stein, Alexander MD

340 Fourth Ave Ste 14

Chula Vista, CA 91910

(619) 303-3681

Provider ID: 213494

License: A106295

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: French,

Romanian

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Uebelhoer, Nathan DO

786 Third Ave Ste B

Chula Vista, CA 91910

(619) 425-0797

Provider ID: 265837

License: 20A9328

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

EL CAJON

92020

Celano, Nicholas MD

292 Avocado Ave

El Cajon, CA 92020

(619) 579-5115

Provider ID: 102191

License: A120411

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Chiang, Jennifer MD

292 Avocado Ave

El Cajon, CA 92020

(619) 579-5115

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 383

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Provider ID: 107659

License: A120528

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Chinese,

Mandarin, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Kassab, Ghada MD

330 S Magnolia Ave

El Cajon, CA 92020

(858) 273-2726

Provider ID: 245636

License: A114457

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Resh, William MD

292 Avocado Ave

El Cajon, CA 92020

(619) 579-5115

Provider ID: 127511

License: C34661

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Sateesh, Brooke MD

292 Avocado Ave

El Cajon, CA 92020

(619) 579-5115

Provider ID: 269153

License: A109670

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ENCINITAS

92024

Gladsjo, Julie MD

477 N El Camino Real Ste D308

Encinitas, CA 92024

(760) 436-2300

Provider ID: 207589

License: A98641

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 384

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

NATIONAL CITY

91950

Brogan, Jacqueline MD

655 Euclid Ave Ste 401

National City, CA 91950

(619) 267-8303

Provider ID: 265495

License: A160890

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Cohen, Philip MD

655 Euclid Ave Ste 401

National City, CA 91950

(619) 267-8303

Provider ID: 202209

License: G89274

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Crowley, Christopher MD

655 Euclid Ave Ste 401

National City, CA 91950

(619) 267-8303

Provider ID: 241929

License: A134188

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Celano, Nicholas MD

655 Euclid Ave Ste 401

National City, CA 91950

(619) 267-8303

Provider ID: 102706

License: A120411

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Chiang, Jennifer MD

655 Euclid Ave Ste 401

National City, CA 91950

(619) 267-8303

Provider ID: 107662

License: A120528

Credentials and/or board

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 385

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Chinese,

Mandarin, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Nelson, Aislyn MD

655 Euclid Ave Ste 401

National City, CA 91950

(619) 267-8303

Provider ID: 242069

License: A147913

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Resh, William MD

655 Euclid Ave Ste 401

National City, CA 91950

(619) 267-8303

Provider ID: 204467

License: C34661

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Sateesh, Brooke MD

655 Euclid Ave Ste 401

National City, CA 91950

(619) 267-8303

Provider ID: 127497

License: A109670

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

POWAY

92064

Calame, Antoanella MD

15725 Pomerado Rd Ste 102

Poway, CA 92064

(858) 397-5755

Provider ID: 208891

License: A84455

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Romanian

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 386

Page 409: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Uebelhoer, Nathan DO

15725 Pomerado Rd Ste 102

Poway, CA 92064

(858) 397-5755

Provider ID: 128022

License: 20A9328

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92103

Hamman, Michael MD

4060 4th Ave Ste 415

San Diego, CA 92103

(619) 298-9809

Provider ID: 208085

License: A97551

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Hemperly, Stephen DO

4060 4th Ave Ste 415

San Diego, CA 92103

(619) 298-9809

Provider ID: 208070

License: 20A14658

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Reed, Kelly DO

4060 4th Ave Ste 415

San Diego, CA 92103

(619) 298-9809

Provider ID: 207628

License: 20A15550

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Shiell, Ronald MD

4060 4th Ave Ste 415

San Diego, CA 92103

(619) 289-9809

Provider ID: 207624

License: G70359

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 387

Page 410: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Zaleski Larsen, Lisa DO

4060 4th Ave Ste 415

San Diego, CA 92103

(619) 298-9809

Provider ID: 208273

License: 20A13774

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92117

Kassab, Ghada MD

3737 Moraga Ave Ste A206

San Diego, CA 92117

(858) 273-2726

Provider ID: 245637

License: A114457

Credentials and/or board

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

certification: No

Accepting New Members: Yes

accessibility needs when there

is limited access or when

Hours: M-SA 9AM-5PM accessibility indicators are not

PTA: No

Other Language: Arabic,

present.

Spanish

Cultural Competency: NR Brouha, Brook MD

Accessibility: B; Members 9339 Genesee Ave Ste 350-a

should call the provider’s

office to discuss their

accessibility needs when there

San Diego, CA 92121

(858) 263-0571

Provider ID: 257317

is limited access or when License: A97902

accessibility indicators are not

present.

Credentials and/or board

certification: No

92121

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Boen, Monica MD

9339 Genesee Ave Ste 350

San Diego, CA 92121

(858) 454-4300

Provider ID: 207594

Other Language: French

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

License: A149554

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Special Expertise: HIV/AIDS

Other Language: French,

Polish, Spanish Tompkins, Stacy MD

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 388

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

9339 Genesee Ave Ste 350

San Diego, CA 92121

(858) 454-4300

Provider ID: 207967

License: A52958

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: French,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Uebelhoer, Nathan DO

6605 Nancy Ridge Dr

San Diego, CA 92121

(858) 900-2700

Provider ID: 128021

License: 20A9328

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92122

Keel, Douglas DO

8899 University Center Ln Ste

150

San Diego, CA 92122

(858) 535-1400

Provider ID: 127852

License: 20A7081

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92123

Nahm, Walter MD

7695 Cardinal Ct Ste 200

San Diego, CA 92123

(858) 278-8835

Provider ID: 241922

License: A78569

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Korean,

Spanish, Tagalog

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Diabetes Specialist

CHULA VISTA

91910

Argoud, Georges MD

340 Fourth Ave Ste 7a

Chula Vista, CA 91910

(619) 691-0388

Provider ID: 217420

License: G61898

Credentials and/or board

certification: No

Accepting New Members: Yes

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 389

Page 412: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Emergency Medicine

Alcalde, Victor MD

333 H St Ste 2080

Chula Vista, CA 91910

(619) 662-4100

Provider ID: 276253

License: A170657

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Carstairs, Shaun MD

333 H St Ste 2080

Chula Vista, CA 91910

(619) 662-4100

Provider ID: 276248

License: A71434

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Dillman, Ariana MD

333 H St Ste 2080

Chula Vista, CA 91910

(619) 662-4100

Provider ID: 276244

License: A118150

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Einstein, Eric MD

333 H St Ste 2080

Chula Vista, CA 91910

(619) 662-4100

Provider ID: 276249

License: A134524

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

French, Tonianne MD

333 H St Ste 2080

Chula Vista, CA 91910

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 390

Page 413: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

(619) 662-4100

Provider ID: 276170

License: G74840

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Galasso, Madison MD

333 H St Ste 2080

Chula Vista, CA 91910

(619) 662-4100

Provider ID: 276243

License: A160982

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Griesinger, Michael MD

333 H St Ste 2080

Chula Vista, CA 91910

(619) 662-4100

Provider ID: 276222

License: A155029

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Jost, Peter MD

333 H St Ste 2080

Chula Vista, CA 91910

(619) 662-4100

Provider ID: 276191

License: A81661

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Kornblatt, Allison MD

333 H St Ste 2080

Chula Vista, CA 91910

(619) 662-4100

Provider ID: 276192

License: A158412

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 391

Page 414: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Lopez, Jason MD should call the provider’s License: 20A10015

333 H St Ste 2080 office to discuss their Credentials and/or board

Chula Vista, CA 91910 accessibility needs when there certification: No

(619) 662-4100 is limited access or when Accepting New Members: Yes

Provider ID: 276186 accessibility indicators are not Hours: M-SA 9AM-5PM

License: A155935 present. PTA: No

Credentials and/or board Cultural Competency: NR

certification: No Accessibility: B; Members

Accepting New Members: Yes Quenzer, Faith DO should call the provider’s

Hours: M-SA 9AM-5PM 333 H St Ste 2080 office to discuss their

PTA: No Chula Vista, CA 91910 accessibility needs when there

Cultural Competency: NR (619) 662-4100 is limited access or when

Accessibility: B; Members Provider ID: 276194 accessibility indicators are not

should call the provider’s License: 20A15401 present.

office to discuss their Credentials and/or board

accessibility needs when there certification: No

is limited access or when Accepting New Members: Yes Riccoboni, Steven MD

accessibility indicators are not Hours: M-SA 9AM-5PM 333 H St Ste 2080

present. PTA: No Chula Vista, CA 91910

Cultural Competency: NR (619) 662-4100

Accessibility: B; Members Provider ID: 276232

Portillo, Tania MD should call the provider’s License: A133402

333 H St Ste 2080 office to discuss their Credentials and/or board

Chula Vista, CA 91910 accessibility needs when there certification: No

(619) 662-4100 is limited access or when Accepting New Members: Yes

Provider ID: 276207 accessibility indicators are not Hours: M-SA 9AM-5PM

License: A141013 present. PTA: No

Credentials and/or board Other Language: Italian

certification: No Cultural Competency: NR

Accepting New Members: Yes Reardon, Jacqueline DO Accessibility: B; Members

Hours: M-SA 9AM-5PM 333 H St Ste 2080 should call the provider’s

PTA: No Chula Vista, CA 91910 office to discuss their

Cultural Competency: NR (619) 662-4100 accessibility needs when there

Accessibility: B; Members Provider ID: 276235 is limited access or when

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 392

Page 415: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

accessibility indicators are not

present.

Roxas, Roger MD

333 H St Ste 2080

Chula Vista, CA 91910

(619) 662-4100

Provider ID: 276190

License: A166981

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Steiner, Brian MD

333 H St Ste 2080

Chula Vista, CA 91910

(619) 662-4100

Provider ID: 276187

License: A155350

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Tovar, Juan MD

333 H St Ste 2080

Chula Vista, CA 91910

(619) 662-4100

Provider ID: 276195

License: A72609

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA JOLLA

92037

Mizzell, Joseph MD

9850 Genesee Ave Ste 370

La Jolla, CA 92037

(858) 625-7200

Provider ID: 265327

License: A111893

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92130

Jurkowski, Leonard MD

3830 Valley Centre Dr Ste 702

San Diego, CA 92130

(858) 720-0554

Provider ID: 127825

License: C43217

Credentials and/or board

certification: No

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 393

Page 416: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Endocrinology Metabolism

CHULA VISTA

91910

Philis-tsimikas, Athena MD

678 Third Ave

Chula Vista, CA 91910

(619) 662-4100

Provider ID: 265350

License: A50477

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Greek

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Endocrinology

Vincent, Lauren MD

678 Third Ave

Chula Vista, CA 91910

(619) 662-4100

Provider ID: 265472

License: A134303

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Gastroenterology

Alayo, Erick MD

587 Third Ave

Chula Vista, CA 91910

(619) 382-3315

Provider ID: 43530

License: A107506

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Wiener, Gregory MD

353 Church Ave # A

Chula Vista, CA 91910

(619) 585-8883

Provider ID: 207348

License: A41749

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: French,

Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 394

Page 417: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

CORONADO

92118

Hassanein, Tarek MD

131 Orange Ave Ste 101b

Coronado, CA 92118

(619) 522-0399

Provider ID: 276939

License: A54452

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

French, German, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

EL CAJON

92019

Gish, Robert MD

165 S 1st St

El Cajon, CA 92019

(619) 312-0347

Provider ID: 279968

License: G45632

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Dutch,

French, Spanish, Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92020

Hassanein, Tarek MD

463 N Magnolia Ave

El Cajon, CA 92020

(619) 522-0399

Provider ID: 276938

License: A54452

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

French, German, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92021

Gish, Robert MD

1032 Broadway

El Cajon, CA 92021

(619) 795-5991

Provider ID: 279967

License: G45632

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Dutch,

French, Spanish, Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 395

Page 418: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

present. certification: Yes present.

ENCINITAS

92024

Ally, Mazer MD

477 N El Camino Real Ste A308

Encinitas, CA 92024

(760) 436-8881

Provider ID: 269064

License: A146924

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Dilauro, Steven MD

700 Garden View Ct Ste 102

Encinitas, CA 92024

(760) 783-0441

Provider ID: 257122

License: A104332

Credentials and/or board

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Goldklang, Robert MD

700 Garden View Ct Ste 102

Encinitas, CA 92024

(760) 783-0441

Provider ID: 66037

License: G69237

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

Lajoie, Adrianne MD

700 Garden View Ct Ste 102

Encinitas, CA 92024

(760) 783-0441

Provider ID: 257124

License: A84301

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Singh, Marvin MD

320 Santa Fe Dr Ste 308

Encinitas, CA 92024

(760) 783-0441

Provider ID: 260237

License: A102749

Credentials and/or board

certification: No

Accepting New Members: Yes

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 396

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Korean,

Russian, Spanish, Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA JOLLA

92037

Mayer, Andrew MD

9850 Genesee Ave Ste 820

La Jolla, CA 92037

(858) 453-5200

Provider ID: 65728

License: A77759

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Paredez, Edward MD

9850 Genesee Ave Ste 820

La Jolla, CA 92037

(858) 453-5200

Provider ID: 65734

License: A87900

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

NATIONAL CITY

91950

Gish, Robert MD

217 Highland Ave

National City, CA 91950

(619) 434-7308

Provider ID: 279969

License: G45632

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Dutch,

French, Spanish, Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

OCEANSIDE

92056

Devereaux, Christopher MD

3923 Waring Rd Ste A

Oceanside, CA 92056

(760) 724-8782

Provider ID: 259620

License: G75223

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 397

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accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Krol, Thomas MD

3923 Waring Rd Ste A

Oceanside, CA 92056

(760) 724-8782

Provider ID: 259634

License: G43649

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Shad, Javaid MD

3923 Waring Rd Ste A

Oceanside, CA 92056

(760) 724-8782

Provider ID: 259610

License: G86962

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Hindi, Urdu

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Shim, Michael MD

3923 Waring Rd Ste A

Oceanside, CA 92056

(760) 724-8782

Provider ID: 259633

License: A88942

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Viernes, Matthew MD

3923 Waring Rd Ste A

Oceanside, CA 92056

(760) 724-8782

Provider ID: 259638

License: A61516

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92105

Gish, Robert MD

4060 Fairmount Ave

San Diego, CA 92105

(619) 779-7900

Provider ID: 279965

License: G45632

Credentials and/or board

certification: No

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 398

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Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Dutch,

French, Spanish, Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Gish, Robert MD

4171 Fairmount Ave

San Diego, CA 92105

(619) 269-1269

Provider ID: 279966

License: G45632

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Dutch,

French, Spanish, Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Hearing Aid Dealer / Supplier

CARLSBAD

92008

Davis, Kelle MA

1820 Marron Rd

Carlsbad, CA 92008

(760) 434-0125

Provider ID: 253149

License: HA6083

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Wyman, Wendy MA

1820 Marron Rd Ste 102

Carlsbad, CA 92008

(760) 434-0125

Provider ID: 252978

License: HA8365

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

CHULA VISTA

91910

Anderson, Elaine MA

310 Third Ave Ste B21/c11

Chula Vista, CA 91910

(619) 426-0841

Provider ID: 253459

License: HA7100

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 399

Page 422: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

is limited access or when

accessibility indicators are not

present.

EL CAJON

92021

Dandurand, John MA

1767 E Main St

El Cajon, CA 92021

(619) 440-6516

Provider ID: 252964

License: HA2056

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Davis, Kelle MA

1767 E Main St

El Cajon, CA 92021

(619) 440-6516

Provider ID: 253148

License: HA6083

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ESCONDIDO

92025

Wyman, Wendy MA

330 W Felicita Ave Ste A4

Escondido, CA 92025

(858) 259-4182

Provider ID: 252976

License: HA8365

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92120

Anderson, Elaine MA

6367 Alvarado Ct

San Diego, CA 92120

(619) 583-7002

Provider ID: 252907

License: HA7100

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Dandurand, John MA

6367 Alvarado Ct

San Diego, CA 92120

(858) 259-4182

Provider ID: 252965

License: HA2056

Credentials and/or board

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 400

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certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92123

Anaya, Manuel MA

9340 Clairemont Mesa Blvd Ste

D

San Diego, CA 92123

(858) 278-9911

Provider ID: 265704

License: HA8368

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Davis, Kelle MA

9340 Clairemont Mesa Blvd

San Diego, CA 92123

(760) 434-0125

Provider ID: 253150

License: HA6083

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SOLANA BEACH

92075

Dandurand, John MA

740 Lomas Santa Fe Dr Ste 110

Solana Beach, CA 92075

(858) 259-4182

Provider ID: 252963

License: HA2056

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Wyman, Wendy MA

740 Lomas Santa Fe Dr Ste 110

Solana Beach, CA 92075

(858) 259-4182

Provider ID: 252977

License: HA8365

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 401

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Hematology / Oncology

LA JOLLA

92037

Banerjee, Pushpendu MD

9850 Genesee Ave Ste 560

La Jolla, CA 92037

(858) 552-1410

Provider ID: 54041

License: A69490

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Hindi

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Sinclair, James MD

9850 Genesee Ave Ste 560

La Jolla, CA 92037

(858) 552-1410

Provider ID: 54027

License: G48926

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Wallach, Sabina MD

9850 Genesee Ave Ste 400

La Jolla, CA 92037

(858) 558-8666

Provider ID: 65743

License: A34070

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: French,

Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

OCEANSIDE

92056

Siddique, Nayyar MD

3617 Vista Way

Oceanside, CA 92056

(760) 758-5770

Provider ID: 274776

License: A62744

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Urdu

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Singh, Himani MD

3617 Vista Way

Oceanside, CA 92056

(760) 758-5770

Provider ID: 272698

License: A143620

Credentials and/or board

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 402

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Infectious Disease

LA JOLLA

92037

Barthel, Robert MD

9850 Genesee Ave Ste 900

La Jolla, CA 92037

(858) 626-7780

Provider ID: 212799

License: C55858

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Miller, Howard MD

9834 Genesee Ave Ste 310

La Jolla, CA 92037

(858) 457-8600

Provider ID: 273257

License: C38875

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Internal Medicine Critical

Care Medicine

ENCINITAS

92024

Smilde, Renee MD

662 Encinitas Blvd Ste 220

Encinitas, CA 92024

(833) 446-6363

Provider ID: 271804

License: A70175

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Dutch

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Shin, Stephanie MD

320 Santa Fe Dr Ste 107-c

Encinitas, CA 92024

(760) 230-8994

Provider ID: 260072

License: A130231

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 403

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Tran, Sheri MD

320 Santa Fe Dr Ste 107c

Encinitas, CA 92024

(760) 230-8994

Provider ID: 270757

License: A124071

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA JOLLA

92037

Jones, Daniel MD

9850 Genesee Ave Ste 780

La Jolla, CA 92037

(858) 625-7200

Provider ID: 244322

License: A102945

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92103

Bencheqroun, Hassan MD

501 Washington St Ste 735

San Diego, CA 92103

(760) 618-1353

Provider ID: 238851

License: A112435

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

French, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Internal Medicine

CHULA VISTA

91910

Al-kourainy, Kousay MD

480 4th Ave Ste 409

Chula Vista, CA 91910

(619) 425-2080

Provider ID: 269224

License: A39783

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Arabic,

Spanish, Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 404

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

is limited access or when

accessibility indicators are not

present.

Duque, John MD

480 4th Ave Ste 316

Chula Vista, CA 91910

(619) 691-0240

Provider ID: 244807

License: G48442

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Gollapudi, Raghava MD

450 Fourth Ave Ste 215

Chula Vista, CA 91910

(858) 244-6870

Provider ID: 221390

License: A73392

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Gurudevan, Swaminatha MD

321 E St

Chula Vista, CA 91910

(619) 934-3260

Provider ID: 259771

License: A70212

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Hindi,

Spanish, Tamil

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Hassanein, Tarek MD

303 H St Ste 103

Chula Vista, CA 91910

(619) 522-0399

Provider ID: 279359

License: A54452

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

French, German, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Iturbe-alessio, Ignacio MD

480 4th Ave Ste 409

Chula Vista, CA 91910

(619) 425-2080

Provider ID: 270498

License: A42415

Credentials and/or board

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 405

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

certification: Yes accessibility indicators are not certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish,

Tagalog

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Johnson, Mark MD

480 4th Ave Ste 506

Chula Vista, CA 91910

(619) 585-0313

Provider ID: 257518

License: G28163

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

present.

Moolani, Ramesh MD

480 Fourth Ave Ste 409

Chula Vista, CA 91910

(619) 425-2080

Provider ID: 269218

License: C149851

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: German,

Gujarati, Sindhi

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Ponce, Sonia MD

450 Fourth Ave Ste 215

Chula Vista, CA 91910

(619) 434-0204

Provider ID: 212809

License: A145008

Credentials and/or board

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

91911

Carlson, Steven MD

765 Medical Center Ct Ste 211

Chula Vista, CA 91911

(619) 616-2100

Provider ID: 238127

License: A109957

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 406

Page 429: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

accessibility indicators are not

present.

Mohamedali, Burhan MD

765 Medical Center Ct Ste 211

Chula Vista, CA 91911

(619) 616-2100

Provider ID: 238120

License: A125669

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Swahili

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Narayanan, Meena MD

765 Medical Center Ct Ste 211

Chula Vista, CA 91911

(619) 616-2100

Provider ID: 238132

License: A113448

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Parikh, Milind DO

765 Medical Center Ct Ste 211

Chula Vista, CA 91911

(619) 616-2100

Provider ID: 238194

License: 20A13745

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Rutledge, Michael MD

765 Medical Center Ct Ste 211

Chula Vista, CA 91911

(619) 616-2100

Provider ID: 257159

License: C166106

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

91914

Narula, Arvin MD

890 Eastlake Pkwy Ste 205

Chula Vista, CA 91914

(858) 244-6800

Provider ID: 246870

License: A125186

Credentials and/or board

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 407

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

certification: No accessibility indicators are not certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

EL CAJON

92020

Ponce, Sonia MD

328 Highland Ave Ste 200

El Cajon, CA 92020

(619) 930-9404

Provider ID: 212810

License: A145008

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

present. Accepting New Members: Yes

Hours: M-SA 9AM-5PM

92021 PTA: No

Other Language: Spanish,

Carlson, Steven MD Swahili

1625 E Main St Ste 201 Cultural Competency: NR

El Cajon, CA 92021 Accessibility: B; Members

(619) 486-6512 should call the provider’s

Provider ID: 248317 office to discuss their

License: A109957 accessibility needs when there

Credentials and/or board is limited access or when

certification: No accessibility indicators are not

Accepting New Members: Yes present.

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish Narayanan, Meena MD

Cultural Competency: NR 1625 E Main St Ste 201

Accessibility: B; Members El Cajon, CA 92021

should call the provider’s (619) 486-6512

office to discuss their Provider ID: 248192

accessibility needs when there License: A113448

is limited access or when Credentials and/or board

accessibility indicators are not certification: No

present. Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Mohamedali, Burhan MD Other Language: Farsi,

1625 E Main St Ste 201 Spanish

El Cajon, CA 92021 Cultural Competency: NR

(619) 486-6512 Accessibility: B; Members

Provider ID: 248119 should call the provider’s

License: A125669 office to discuss their

Credentials and/or board accessibility needs when there

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 408

Page 431: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

is limited access or when

accessibility indicators are not

present.

Rutledge, Michael MD

1625 E Main St Ste 201

El Cajon, CA 92021

(619) 486-6512

Provider ID: 278840

License: C166106

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ENCINITAS

92024

Bulibek, Batyrjan MD

320 Santa Fe Dr Ste 204

Encinitas, CA 92024

(760) 944-7300

Provider ID: 265216

License: A148198

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Patel, Janki MD

700 Garden View Ct Ste 102

Encinitas, CA 92024

(760) 783-0441

Provider ID: 257158

License: A133101

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Seeger, Kristina MD

477 N El Camino Real Ste A308

Encinitas, CA 92024

(760) 436-8881

Provider ID: 269058

License: A136185

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Sullivan, Jessica DO

326 Santa Fe Dr Ste 105

Encinitas, CA 92024

(760) 452-3340

Provider ID: 273554

License: 20A16273

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 409

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Singh, Marvin MD

700 Garden View Ct Ste 102

Encinitas, CA 92024

(760) 783-0441

Provider ID: 257154

License: A102749

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Korean,

Russian, Spanish, Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ESCONDIDO

92025

Carlson, Steven MD

488 E Valley Pkwy Ste 107

Escondido, CA 92025

(760) 294-0480

Provider ID: 278818

License: A109957

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Mohamedali, Burhan MD

488 E Valley Pkwy Ste 107

Escondido, CA 92025

(760) 294-0480

Provider ID: 278841

License: A125669

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Swahili

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Narayanan, Meena MD

488 E Valley Pkwy Ste 107

Escondido, CA 92025

(760) 294-0480

Provider ID: 278830

License: A113448

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 410

Page 433: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

present. Hours: M-SA 9AM-5PM present.

Parikh, Milind DO

488 E Valley Pkwy Ste 107

Escondido, CA 92025

(619) 486-6512

Provider ID: 278814

License: 20A13745

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Rutledge, Michael MD

488 E Valley Pkwy Ste 107

Escondido, CA 92025

(760) 294-0480

Provider ID: 278838

License: C166106

Credentials and/or board

certification: No

Accepting New Members: Yes

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

FALLBROOK

92028

Hong, John MD

521 E Elder St Ste 104

Fallbrook, CA 92028

(760) 728-9560

Provider ID: 269014

License: A63582

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Korean

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

LA JOLLA

92037

Buchbinder, Maurice MD

9850 Genesee Ave Ste 780

La Jolla, CA 92037

(858) 824-2900

Provider ID: 257957

License: A38176

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Charlat, Martin MD

9834 Genesee Ave Ste 300

La Jolla, CA 92037

(858) 824-2900

Provider ID: 265336

License: G64921

Credentials and/or board

certification: No

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 411

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Accepting New Members: Yes Other Language: Hindi,

Hours: M-SA 9AM-5PM Spanish, Tamil

PTA: No Damani, Samir MD Cultural Competency: NR

Other Language: French 9850 Genesee Ave Ste 650 Accessibility: B; Members

Cultural Competency: NR La Jolla, CA 92037 should call the provider’s

Accessibility: B; Members (858) 800-2480 office to discuss their

should call the provider’s Provider ID: 275125 accessibility needs when there

office to discuss their License: A88989 is limited access or when

accessibility needs when there Credentials and/or board accessibility indicators are not

is limited access or when certification: No present.

accessibility indicators are not Accepting New Members: Yes

present. Hours: M-SA 9AM-5PM

PTA: No Harrington, John MD

Cultural Competency: NR 9850 Genesee Ave Ste 780

Charlat, Martin MD Accessibility: B; Members La Jolla, CA 92037

9850 Genesee Ave Ste 780 should call the provider’s (858) 450-3388

La Jolla, CA 92037 office to discuss their Provider ID: 252957

(858) 824-2900 accessibility needs when there License: A45573

Provider ID: 272332 is limited access or when Credentials and/or board

License: G64921 accessibility indicators are not certification: No

Credentials and/or board present. Accepting New Members: Yes

certification: No Hours: M-SA 9AM-5PM

Accepting New Members: Yes PTA: No

Hours: M-SA 9AM-5PM Gurudevan, Swaminatha MD Cultural Competency: NR

PTA: No 9834 Genesee Ave Ste 101 Accessibility: B; Members

Other Language: French La Jolla, CA 92037 should call the provider’s

Cultural Competency: NR (858) 430-8455 office to discuss their

Accessibility: B; Members Provider ID: 259770 accessibility needs when there

should call the provider’s License: A70212 is limited access or when

office to discuss their Credentials and/or board accessibility indicators are not

accessibility needs when there certification: No present.

is limited access or when Accepting New Members: Yes

accessibility indicators are not Hours: M-SA 9AM-5PM

present. PTA: No Hong, Eric MD

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 412

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115

SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

9850 Genesee Ave Ste 780

La Jolla, CA 92037

(858) 824-2900

Provider ID: 272353

License: A101767

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA MESA

91942

Boghairi, Anoushiravan MD

5565 Grossmont Center Dr Ste

La Mesa, CA 91942

(619) 698-6667

Provider ID: 210579

License: A33832

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Persian

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Razi, Bijan MD

8851 Center Dr Ste 405

La Mesa, CA 91942

(619) 265-0200

Provider ID: 238787

License: A37882

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Reddy, Reddiwandla MD

5565 Grossmont Center Dr Ste

202

La Mesa, CA 91942

(619) 461-6130

Provider ID: 265392

License: A38098

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Kannada,

Spanish, Telugu

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

NATIONAL CITY

91950

Esfahani, Fatemeh MD

655 Euclid Ave Ste 304

National City, CA 91950

(619) 470-7700

Provider ID: 241971

License: A126659

Credentials and/or board

certification: No

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 413

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Persian

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

OCEANSIDE

92056

Chiao, Hellen MD

3923 Waring Rd Ste A

Oceanside, CA 92056

(760) 724-8782

Provider ID: 259685

License: A127722

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Cantonese,

Mandarin, Spanish,

Taiwanese, Yue Chinese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92103

Chung, Kiyon MD

4060 4th Ave Ste 650

San Diego, CA 92103

(619) 819-7222

Provider ID: 246315

License: C54514

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Korean

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Friedman, Richard MD

4060 4th Ave Ste 650

San Diego, CA 92103

(619) 819-7222

Provider ID: 246324

License: G32430

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92114

Carlson, Steven MD

292 Euclid Ave Ste 210

San Diego, CA 92114

(619) 616-2100

Provider ID: 238128

License: A109957

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 414

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

office to discuss their Provider ID: 238133 office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Mohamedali, Burhan MD

292 Euclid Ave Ste 210

San Diego, CA 92114

(619) 616-2100

Provider ID: 238121

License: A125669

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Swahili

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Narayanan, Meena MD

292 Euclid Ave Ste 210

San Diego, CA 92114

(619) 616-2100

License: A113448

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Parikh, Milind DO

292 Euclid Ave Ste 210

San Diego, CA 92114

(619) 616-2100

Provider ID: 238195

License: 20A13745

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Rutledge, Michael MD

292 Euclid Ave Ste 210

San Diego, CA 92114

(619) 616-2100

Provider ID: 257160

License: C166106

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92123

Gollapudi, Raghava MD

3131 Berger Ave Ste 200

San Diego, CA 92123

(858) 244-6800

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 415

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Provider ID: 221389

License: A73392

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Narula, Arvin MD

3131 Berger Ave Ste 200

San Diego, CA 92123

(858) 244-6800

Provider ID: 218622

License: A125186

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN MARCOS

92078

Carlson, Steven MD

955 Boardwalk Ste 100

San Marcos, CA 92078

(760) 798-8855

Provider ID: 238129

License: A109957

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Mohamedali, Burhan MD

955 Boardwalk Ste 100

San Marcos, CA 92078

(760) 798-8855

Provider ID: 238122

License: A125669

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Swahili

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Narayanan, Meena MD

955 Boardwalk Ste 100

San Marcos, CA 92078

(760) 798-8855

Provider ID: 238134

License: A113448

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 416

Page 439: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Rutledge, Michael MD

955 Boardwalk Ste 100

San Marcos, CA 92078

(760) 798-8855

Provider ID: 278839

License: C166106

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Interventional Cardiology

EL CAJON

92020

Omran, Jad MD

300 S Pierce St Ste 102

El Cajon, CA 92020

(619) 668-4700

Provider ID: 241942

License: A144651

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ENCINITAS

92024

Yturralde, Frederick MD

700 Garden View Ct Ste 204

Encinitas, CA 92024

(760) 452-6334

Provider ID: 276086

License: C168384

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Yturralde, Frederick MD

354 Santa Fe Dr

Encinitas, CA 92024

(760) 452-6334

Provider ID: 276087

License: C168384

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA JOLLA

92037

Rapeport, Kevin MD

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 417

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

9850 Genesee Ave Ste 940b

La Jolla, CA 92037

(858) 864-1400

Provider ID: 265292

License: A43603

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Maternal and Fetal Medicine

EL CAJON

92019

Faksh, Arij DO

165 S 1st St

El Cajon, CA 92019

(619) 312-0347

Provider ID: 278441

License: 20A14222

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92021

Faksh, Arij DO

1032 Broadway

El Cajon, CA 92021

(619) 795-5991

Provider ID: 278442

License: 20A14222

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

NATIONAL CITY

91950

Faksh, Arij DO

217 Highland Ave

National City, CA 91950

(619) 434-7308

Provider ID: 278443

License: 20A14222

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92105

Faksh, Arij DO

4060 Fairmount Ave

San Diego, CA 92105

(619) 280-7072

Provider ID: 278440

License: 20A14222

Credentials and/or board

certification: No

Accepting New Members: Yes

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 418

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Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92130

Ahn, Jennifer MD

12264 El Camino Real Ste 204

San Diego, CA 92130

(858) 794-7700

Provider ID: 273140

License: C160026

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Dowling, David MD

12264 El Camino Real Ste 204

San Diego, CA 92130

(858) 794-7700

Provider ID: 127779

License: G80714

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Gollin, Yvonne MD

12264 El Camino Real Ste 204

San Diego, CA 92130

(858) 794-7700

Provider ID: 127801

License: G85078

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Medical Oncology

OCEANSIDE

92056

Paroly, Warren MD

3617 Vista Way

Oceanside, CA 92056

(760) 758-5770

Provider ID: 272516

License: G29867

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 419

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SAN MARCOS

92069

Kosmo, Michael MD

838 Nordahl Rd Ste 300

San Marcos, CA 92069

(760) 747-8935

Provider ID: 53701

License: G54074

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: French,

German, Spanish, Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Nephrology

CHULA VISTA

91910

Bedoya, Luis MD

340 4th Ave Ste 4

Chula Vista, CA 91910

(619) 427-1144

Provider ID: 210600

License: A51105

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Horeish, Adam MD

340 4th Ave Ste 4

Chula Vista, CA 91910

(619) 427-1144

Provider ID: 210543

License: C56089

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Khaing, Kathy MD

340 4th Ave Ste 4

Chula Vista, CA 91910

(619) 427-1144

Provider ID: 210574

License: A127006

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Burmese,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Lozada-pastorio, Elizabeth MD

340 4th Ave Ste 4

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 420

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Chula Vista, CA 91910 should call the provider’s Provider ID: 213987

(619) 427-1144 office to discuss their License: A68995

Provider ID: 212909 accessibility needs when there Credentials and/or board

License: A90108 is limited access or when certification: Yes

Credentials and/or board accessibility indicators are not Accepting New Members: Yes

certification: No present. Hours: M-SA 9AM-5PM

Accepting New Members: Yes PTA: Yes

Hours: M-SA 9AM-5PM Other Language: Spanish

PTA: Yes Patel, Amar MD Cultural Competency: NR

Other Language: Spanish 340 Fourth Ave Ste 4 Accessibility: B; Members

Cultural Competency: NR Chula Vista, CA 91910 should call the provider’s

Accessibility: B; Members (858) 810-8000 office to discuss their

should call the provider’s Provider ID: 245184 accessibility needs when there

office to discuss their License: A158295 is limited access or when

accessibility needs when there Credentials and/or board accessibility indicators are not

is limited access or when certification: No present.

accessibility indicators are not Accepting New Members: Yes

present. Hours: M-SA 9AM-5PM

PTA: No Thomas, Theodore MD

Other Language: Gujarati Contract terminated as of

Meyer, Jill MD Cultural Competency: NR 8/31/2021

340 4th Ave Ste 4 Accessibility: B; Members 786 Third Ave Ste B

Chula Vista, CA 91910 should call the provider’s Chula Vista, CA 91910

(619) 427-1144 office to discuss their (619) 425-0797

Provider ID: 212814 accessibility needs when there Provider ID: 263217

License: A95882 is limited access or when License: G61681

Credentials and/or board accessibility indicators are not Credentials and/or board

certification: Yes present. certification: No

Accepting New Members: Yes Accepting New Members: No

Hours: M-SA 9AM-5PM Hours: M-SA 9AM-5PM

PTA: Yes Soltero, Ricardo MD PTA: No

Other Language: Spanish 340 4th Ave Ste 4 Other Language: Spanish

Cultural Competency: NR Chula Vista, CA 91910 Cultural Competency: NR

Accessibility: B, W; Members (619) 427-1144 Accessibility: B; Members

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 421

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

should call the provider’s (619) 425-0797 Accessibility: B; Members

office to discuss their Provider ID: 265229 should call the provider’s

accessibility needs when there License: A49216 office to discuss their

is limited access or when Credentials and/or board accessibility needs when there

accessibility indicators are not certification: No is limited access or when

present. Accepting New Members: Yes accessibility indicators are not

Hours: M-SA 9AM-5PM present.

PTA: No

Videen, John MD Other Language: Spanish,

786 Third Ave Ste B Tamil Meyer, Jill MD

Chula Vista, CA 91910 Cultural Competency: NR 752 Medical Center Ct Ste 302

(619) 425-0797 Accessibility: B; Members Chula Vista, CA 91911

Provider ID: 265266 should call the provider’s (619) 421-3361

License: G59271 office to discuss their Provider ID: 212815

Credentials and/or board accessibility needs when there License: A95882

certification: No is limited access or when Credentials and/or board

Accepting New Members: Yes accessibility indicators are not certification: No

Hours: M-SA 9AM-5PM present. Accepting New Members: Yes

PTA: No Hours: M-SA 9AM-5PM

Other Language: Spanish 91911 PTA: No

Cultural Competency: NR Other Language: Spanish

Accessibility: B; Members Lozada-pastorio, Elizabeth MD Cultural Competency: NR

should call the provider’s 752 Medical Center Ct Ste 302 Accessibility: B; Members

office to discuss their Chula Vista, CA 91911 should call the provider’s

accessibility needs when there (619) 421-3361 office to discuss their

is limited access or when Provider ID: 212910 accessibility needs when there

accessibility indicators are not License: A90108 is limited access or when

present. Credentials and/or board accessibility indicators are not

certification: No present.

Accepting New Members: Yes

Wijeyakumar, Vijayalakshmi Hours: M-SA 9AM-5PM

MD PTA: No Videen, John MD

786 Third Ave Ste B Other Language: Spanish 752 Medical Center Ct Ste 302

Chula Vista, CA 91910 Cultural Competency: NR Chula Vista, CA 91911

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 422

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

(619) 421-3361

Provider ID: 212802

License: G59271

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Vyas, Dhwanil MD

752 Medical Center Ct Ste 302

Chula Vista, CA 91911

(619) 421-3361

Provider ID: 210420

License: A125364

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Gujarati,

Hindi, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

91914

Gollapudi, Raghava MD

890 Eastlake Pkwy Ste 205

Chula Vista, CA 91914

(858) 244-6800

Provider ID: 246813

License: A73392

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

CORONADO

92118

Hammes, John MD

230 Prospect Pl Ste 340b

Coronado, CA 92118

(619) 299-2350

Provider ID: 214242

License: G84351

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: French,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ENCINITAS

92024

Lakhera, Yogita MD

320 Santa Fe Dr Ste 212

Encinitas, CA 92024

(760) 509-1040

Provider ID: 109347

License: A125173

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 423

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

PTA: No certification: No

Other Language: Hindi

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ESCONDIDO

92025

Greenstein, Joshua MD

631 E Grand Ave

Escondido, CA 92025

(760) 294-1660

Provider ID: 53809

License: A68100

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Hebreo, Joseph MD

631 E Grand Ave

Escondido, CA 92025

(760) 294-1660

Provider ID: 108435

License: A93436

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Kayal, Anas MD

Contract terminated as of

6/30/2021

631 E Grand Ave

Escondido, CA 92025

(760) 294-1660

Provider ID: 82436

License: A112450

Credentials and/or board

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Khawar, Osman MD

631 E Grand Ave

Escondido, CA 92025

(760) 294-1660

Provider ID: 53715

License: A92165

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Urdu

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 424

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

accessibility indicators are not certification: No office to discuss their

present.

Neyaz, Mohammed DO

631 E Grand Ave

Escondido, CA 92025

(760) 294-1660

Provider ID: 108420

License: 20A13534

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Hindi,

Spanish, Urdu

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Shapiro, Mark MD

631 E Grand Ave

Escondido, CA 92025

(760) 294-1660

Provider ID: 54458

License: G65280

Credentials and/or board

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Swahili

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA JOLLA

92037

Boiskin, Mark MD

9834 Genesee Ave Ste 312

La Jolla, CA 92037

(858) 558-8150

Provider ID: 40762

License: A52055

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Afrikaans,

Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Comunale, Roderick MD

6501 La Jolla Blvd

La Jolla, CA 92037

(858) 551-0276

Provider ID: 270592

License: A43885

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Friend, Peter MD

9850 Genesee Ave Ste 420

La Jolla, CA 92037

(858) 453-9460

Provider ID: 54226

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 425

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License: G22253

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Steer, Dylan MD

9834 Genesee Ave Ste 312

La Jolla, CA 92037

(858) 558-8150

Provider ID: 31399

License: A65604

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Torosian, Karo DO

9834 Genesee Ave Ste 312

La Jolla, CA 92037

(858) 558-8150

Provider ID: 118749

License: 20A12445

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Armenian,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA MESA

91942

Do, Luan MD

8851 Center Dr Ste 505

La Mesa, CA 91942

(619) 461-3880

Provider ID: 213088

License: A65161

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Fadda, George MD

8851 Center Dr Ste 505

La Mesa, CA 91942

(619) 461-3880

Provider ID: 241957

License: A44918

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

French

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 426

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

accessibility needs when there License: G83902 office to discuss their

is limited access or when

accessibility indicators are not

present.

Miller, Lucy MD

8851 Center Dr Ste 505

La Mesa, CA 91942

(619) 461-3880

Provider ID: 212712

License: A53843

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Japanese,

Portuguese, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Thompson, John MD

8851 Center Dr Ste 505

La Mesa, CA 91942

(619) 461-3880

Provider ID: 214255

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

NATIONAL CITY

91950

Comunale, Roderick MD

502 Euclid Ave Ste 205

National City, CA 91950

(858) 551-0276

Provider ID: 270591

License: A43885

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Calderon Molina, Juan MD

655 Euclid Ave Ste 303

National City, CA 91950

(619) 585-4370

Provider ID: 213112

License: C143845

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: German,

Spanish, Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Maa Chip, Fharak MD

655 Euclid Ave Ste 303

National City, CA 91950

(619) 475-4900

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 427

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Provider ID: 212900

License: A117604

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Sacamay, Tagumpay MD

655 Euclid Ave Ste 303

National City, CA 91950

(619) 475-4900

Provider ID: 212753

License: A62631

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish,

Tagalog

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

OCEANSIDE

92056

Barager, Richard MD

3300 Vista Way Ste B

Oceanside, CA 92056

(760) 967-9900

Provider ID: 39437

License: G52074

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Kyaw, Naing MD

3300 Vista Way

Oceanside, CA 92056

(760) 967-9900

Provider ID: 68200

License: A97469

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Burmese,

Chinese, Mandarin, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Matayoshi, Amy MD

3300 Vista Way Ste B

Oceanside, CA 92056

(760) 967-9900

Provider ID: 54126

License: A60790

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 428

Page 451: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92102

Quevedo, Juan MD

995 Gateway Center Way Ste

207

San Diego, CA 92102

(619) 263-9729

Provider ID: 252941

License: A144881

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92103

Baranski, Joel MD

4060 4th Ave Ste 220

San Diego, CA 92103

(619) 299-2350

Provider ID: 211830

License: G67559

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Davis, Jason MD

4060 Fourth Ave Ste 220

San Diego, CA 92103

(619) 299-2350

Provider ID: 214288

License: A100799

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Hammes, John MD

4060 Fourth Ave Ste 220

San Diego, CA 92103

(619) 299-2350

Provider ID: 214243

License: G84351

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: French,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Thomas, Theodore MD

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 429

Page 452: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Contract terminated as of

8/31/2021

4060 4th Ave Ste 220

San Diego, CA 92103

(619) 299-2350

Provider ID: 241948

License: G61681

Credentials and/or board

certification: Yes

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92115

Behrend, Terry MD

6402 El Cajon Blvd Ste 100

San Diego, CA 92115

(619) 582-4490

Provider ID: 257272

License: A75812

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No Namazy, David MD

Cultural Competency: NR 6402 El Cajon Blvd Ste 102

Accessibility: B; Members San Diego, CA 92115

should call the provider’s (858) 810-8092

office to discuss their Provider ID: 214330

accessibility needs when there License: A74630

is limited access or when Credentials and/or board

accessibility indicators are not certification: No

present. Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Le, Charles MD Other Language: Spanish

4440 Euclid Ave Cultural Competency: NR

San Diego, CA 92115 Accessibility: B; Members

(619) 521-6812 should call the provider’s

Provider ID: 238373 office to discuss their

License: A124891 accessibility needs when there

Credentials and/or board is limited access or when

certification: No accessibility indicators are not

Accepting New Members: Yes present.

Hours: M-SA 9AM-5PM

PTA: Yes 92123 Other Language: Spanish,

Vietnamese Behrend, Terry MD

Cultural Competency: NR 8010 Frost St Ste 510

Accessibility: B; Members San Diego, CA 92123

should call the provider’s (619) 582-4490

office to discuss their Provider ID: 214025

accessibility needs when there License: A75812

is limited access or when Credentials and/or board

accessibility indicators are not certification: No

present. Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 430

Page 453: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Cultural Competency: NR 8010 Frost St Ste 510 Cultural Competency: NR

Accessibility: B; Members San Diego, CA 92123 Accessibility: B; Members

should call the provider’s (858) 637-4800 should call the provider’s

office to discuss their Provider ID: 214289 office to discuss their

accessibility needs when there License: A100799 accessibility needs when there

is limited access or when Credentials and/or board is limited access or when

accessibility indicators are not certification: No accessibility indicators are not

present. Accepting New Members: Yes present.

Hours: M-SA 9AM-5PM

PTA: No

Chongkrairatanakul, Tepsiri Other Language: Spanish Lund, Guy MD

MD Cultural Competency: NR 8010 Frost St Ste 510

8010 Frost St Ste 510 Accessibility: B; Members San Diego, CA 92123

San Diego, CA 92123 should call the provider’s (858) 637-4700

(858) 637-4700 office to discuss their Provider ID: 214199

Provider ID: 213779 accessibility needs when there License: A68839

License: C157995 is limited access or when Credentials and/or board

Credentials and/or board accessibility indicators are not certification: No

certification: No present. Accepting New Members: Yes

Accepting New Members: Yes Hours: M-SA 9AM-5PM

Hours: M-SA 9AM-5PM PTA: No

PTA: No Faravardeh, Arman MD Other Language: Slovak,

Other Language: Thai 8010 Frost St Ste 510 Spanish

Cultural Competency: NR San Diego, CA 92123 Cultural Competency: NR

Accessibility: B; Members (858) 637-4800 Accessibility: B; Members

should call the provider’s Provider ID: 82852 should call the provider’s

office to discuss their License: A94375 office to discuss their

accessibility needs when there Credentials and/or board accessibility needs when there

is limited access or when certification: No is limited access or when

accessibility indicators are not Accepting New Members: Yes accessibility indicators are not

present. Hours: M-SA 9AM-5PM present.

PTA: No

Other Language: Farsi,

Davis, Jason MD Swedish Patel, Bijal MD

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 431

Page 454: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

8010 Frost St Ste 510

San Diego, CA 92123

(858) 637-4800

Provider ID: 214154

License: A74638

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92131

Karippot, Anoop MD

10672 Wexford St Ste 280

San Diego, CA 92131

(858) 412-7362

Provider ID: 127806

License: C54071

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Hindi,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN YSIDRO

92173

Soltero, Ricardo MD

4004 Beyer Blvd

San Ysidro, CA 92173

(619) 662-4100

Provider ID: 265281

License: A68995

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Neurology

CARLSBAD

92008

Ho, Gilbert MD

5814 Van Allen Way Ste 209

Carlsbad, CA 92008

(760) 814-8050

Provider ID: 212732

License: A55117

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Taiwanese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Mehta, Ritvik MD

2390 Faraday Ave

Carlsbad, CA 92008

(858) 909-0770

Provider ID: 240603

License: A93336

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 432

Page 455: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Gujarati,

Hindi

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92011

Blumenfeld, Andrew MD

6010 Hidden Valley Rd Ste 200

Carlsbad, CA 92011

(760) 631-3000

Provider ID: 252872

License: A47863

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Choudry, Bilal MD

6010 Hidden Valley Rd Ste 200

Carlsbad, CA 92011

(760) 631-3000

Provider ID: 252908

License: A114607

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Urdu

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Delaney, Michael MD

6010 Hidden Valley Rd Ste 200

Carlsbad, CA 92011

(760) 631-6000

Provider ID: 252864

License: C146015

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Desadier, Laura DO

6010 Hidden Valley Rd Ste 200

Carlsbad, CA 92011

(760) 631-3000

Provider ID: 252879

License: 20A14045

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 433

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

accessibility indicators are not

present.

Frishberg, Benjamin MD

6010 Hidden Valley Rd Ste 200

Carlsbad, CA 92011

(760) 631-3000

Provider ID: 252878

License: G43493

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Gokaldas, Reshma MD

6010 Hidden Valley Rd Ste 200

Carlsbad, CA 92011

(760) 631-3000

Provider ID: 252862

License: A138459

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Gualberto, Gary MD

6010 Hidden Valley Rd Ste 200

Carlsbad, CA 92011

(760) 631-3000

Provider ID: 252880

License: C138319

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Hall, Jacob MD

6010 Hidden Valley Rd Ste 200

Carlsbad, CA 92011

(760) 631-3000

Provider ID: 269788

License: A132420

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Lobatz, Michael MD

6010 Hidden Valley Rd Ste 200

Carlsbad, CA 92011

(760) 631-3000

Provider ID: 252974

License: G38353

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 434

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

PTA: No Lawler, Abigail MD Cultural Competency: NR

Other Language: Hebrew, 6010 Hidden Valley Rd Ste 200 Accessibility: B; Members

Spanish Carlsbad, CA 92011 should call the provider’s

Cultural Competency: NR (760) 631-3000 office to discuss their

Accessibility: B; Members Provider ID: 252955 accessibility needs when there

should call the provider’s License: A152080 is limited access or when

office to discuss their Credentials and/or board accessibility indicators are not

accessibility needs when there certification: No present.

is limited access or when Accepting New Members: Yes

accessibility indicators are not Hours: M-SA 9AM-5PM

present. PTA: No Oh, Irene MD

Other Language: Spanish 6010 Hidden Valley Rd Ste 200

Cultural Competency: NR Carlsbad, CA 92011

Lane, Richard MD Accessibility: B; Members (760) 631-3000

6010 Hidden Valley Rd Ste 200 should call the provider’s Provider ID: 253017

Carlsbad, CA 92011 office to discuss their License: A106450

(760) 631-3000 accessibility needs when there Credentials and/or board

Provider ID: 270431 is limited access or when certification: No

License: A160001 accessibility indicators are not Accepting New Members: Yes

Credentials and/or board present. Hours: M-SA 9AM-5PM

certification: No PTA: No

Accepting New Members: Yes Other Language: Spanish

Hours: M-SA 9AM-5PM Nielsen, Amy DO Cultural Competency: NR

PTA: No 6010 Hidden Valley Rd Ste 200 Accessibility: B; Members

Cultural Competency: NR Carlsbad, CA 92011 should call the provider’s

Accessibility: B; Members (760) 631-3000 office to discuss their

should call the provider’s Provider ID: 277704 accessibility needs when there

office to discuss their License: 20A11494 is limited access or when

accessibility needs when there Credentials and/or board accessibility indicators are not

is limited access or when certification: No present.

accessibility indicators are not Accepting New Members: Yes

present. Hours: M-SA 9AM-5PM

PTA: No Omuro, Arthur DO

Other Language: Spanish 6010 Hidden Valley Rd Ste 200

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 435

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Carlsbad, CA 92011 should call the provider’s Provider ID: 253742

(760) 631-3000 office to discuss their License: A62263

Provider ID: 270477 accessibility needs when there Credentials and/or board

License: 20A15164 is limited access or when certification: No

Credentials and/or board accessibility indicators are not Accepting New Members: Yes

certification: No present. Hours: M-SA 9AM-5PM

Accepting New Members: Yes PTA: No

Hours: M-SA 9AM-5PM Other Language: Spanish

PTA: No Sadoff, Mark MD Cultural Competency: NR

Cultural Competency: NR 6010 Hidden Valley Rd Ste 200 Accessibility: B; Members

Accessibility: B; Members Carlsbad, CA 92011 should call the provider’s

should call the provider’s (760) 631-3000 office to discuss their

office to discuss their Provider ID: 253701 accessibility needs when there

accessibility needs when there License: G42818 is limited access or when

is limited access or when Credentials and/or board accessibility indicators are not

accessibility indicators are not certification: Yes present.

present. Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No Schim, Jack MD

Paduga, Remia MD Other Language: Spanish 6010 Hidden Valley Rd Ste 200

6010 Hidden Valley Rd Ste 200 Cultural Competency: NR Carlsbad, CA 92011

Carlsbad, CA 92011 Accessibility: B; Members (760) 631-3000

(760) 631-3000 should call the provider’s Provider ID: 252939

Provider ID: 252983 office to discuss their License: G48807

License: A113451 accessibility needs when there Credentials and/or board

Credentials and/or board is limited access or when certification: Yes

certification: No accessibility indicators are not Accepting New Members: Yes

Accepting New Members: Yes present. Hours: M-SA 9AM-5PM

Hours: M-SA 9AM-5PM PTA: No

PTA: No Other Language: Spanish

Other Language: Spanish, Sahagian, Gregory MD Cultural Competency: NR

Tagalog 6010 Hidden Valley Rd Ste 200 Accessibility: B; Members

Cultural Competency: NR Carlsbad, CA 92011 should call the provider’s

Accessibility: B; Members (760) 631-3000 office to discuss their

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 436

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Wang, Anchi MD

6010 Hidden Valley Rd Ste 200

Carlsbad, CA 92011

(760) 631-3000

Provider ID: 52465

License: A79381

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Mandarin,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Wang, Chunyang MD

6010 Hidden Valley Rd Ste 200

Carlsbad, CA 92011

(760) 631-3000

Provider ID: 253007

License: A105660

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Mandarin,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ESCONDIDO

92029

Delaney, Michael MD

1955 Citracado Pkwy Ste 102

Escondido, CA 92029

(760) 631-3000

Provider ID: 252865

License: C146015

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Frishberg, Benjamin MD

1955 Citracado Pkwy Ste 102

Escondido, CA 92029

(760) 631-3000

Provider ID: 252877

License: G43493

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Gokaldas, Reshma MD

1955 Citracado Pkwy Ste 102

Escondido, CA 92029

(760) 631-3000

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 437

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Provider ID: 252863 accessibility needs when there Credentials and/or board

License: A138459 is limited access or when certification: No

Credentials and/or board accessibility indicators are not Accepting New Members: Yes

certification: No present. Hours: M-SA 9AM-5PM

Accepting New Members: Yes PTA: No

Hours: M-SA 9AM-5PM Other Language: Mandarin,

PTA: No Oh, Irene MD Spanish

Other Language: Spanish 1955 Citracado Pkwy Ste 102 Cultural Competency: NR

Cultural Competency: NR Escondido, CA 92029 Accessibility: B; Members

Accessibility: B; Members (760) 631-3000 should call the provider’s

should call the provider’s Provider ID: 253018 office to discuss their

office to discuss their License: A106450 accessibility needs when there

accessibility needs when there Credentials and/or board is limited access or when

is limited access or when certification: No accessibility indicators are not

accessibility indicators are not Accepting New Members: Yes present.

present. Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish Wang, Chunyang MD

Lawler, Abigail MD Cultural Competency: NR 1955 Citracado Pkwy Ste 102

1955 Citracado Pkwy Ste 102 Accessibility: B; Members Escondido, CA 92029

Escondido, CA 92029 should call the provider’s (760) 631-3000

(760) 631-3000 office to discuss their Provider ID: 277705

Provider ID: 252956 accessibility needs when there License: A105660

License: A152080 is limited access or when Credentials and/or board

Credentials and/or board accessibility indicators are not certification: No

certification: No present. Accepting New Members: Yes

Accepting New Members: Yes Hours: M-SA 9AM-5PM

Hours: M-SA 9AM-5PM PTA: No

PTA: No Wang, Anchi MD Other Language: Mandarin,

Other Language: Spanish 1955 Citracado Pkwy Ste 102 Spanish

Cultural Competency: NR Escondido, CA 92029 Cultural Competency: NR

Accessibility: B; Members (760) 631-3000 Accessibility: B; Members

should call the provider’s Provider ID: 252992 should call the provider’s

office to discuss their License: A79381 office to discuss their

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 438

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA JOLLA

92037

Blumenfeld, Andrew MD

9850 Genesee Ave Ste 470

La Jolla, CA 92037

(760) 631-3000

Provider ID: 252871

License: A47863

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Blumenfeld, Andrew MD

9850 Genesee Ave Ste 530

La Jolla, CA 92037

(760) 631-3000

Provider ID: 277679

License: A47863

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Gualberto, Gary MD

9850 Genesee Ave Ste 530

La Jolla, CA 92037

(760) 631-3000

Provider ID: 277092

License: C138319

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Kocharian, Naira MD

9850 Genesee Ave Ste 340

La Jolla, CA 92037

(858) 750-2166

Provider ID: 271037

License: A93881

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Armenian,

Russian

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Nielsen, Amy DO

9850 Genesee Ave Ste 530

La Jolla, CA 92037

(760) 631-3000

Provider ID: 277012

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 439

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

License: 20A11494

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Sadoff, Mark MD

9850 Genesee Ave Ste 530

La Jolla, CA 92037

(760) 631-3000

Provider ID: 277102

License: G42818

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Sahagian, Gregory MD

9850 Genesee Ave Ste 530

La Jolla, CA 92037

(760) 631-3000

Provider ID: 276977

License: A62263

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA MESA

91942

Mohammad, Ahmad Shah MD

8851 Center Dr Ste 307

La Mesa, CA 91942

(619) 337-7900

Provider ID: 212771

License: A98831

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Arabic,

Farsi, French, German,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

NATIONAL CITY

91950

Kugel, Samuel MD

502 Euclid Ave Ste 305

National City, CA 91950

(619) 472-2600

Provider ID: 244863

License: A54412

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Portuguese,

Spanish

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 440

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

POWAY

92064

Blumenfeld, Andrew MD

15611 Pomerado Rd Ste 505

Poway, CA 92064

(760) 631-3000

Provider ID: 277678

License: A47863

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Delaney, Michael MD

15611 Pomerado Rd Ste 505

Poway, CA 92064

(760) 631-3000

Provider ID: 252866

License: C146015

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Ho, Gilbert MD

15644 Pomerado Rd Ste 401

Poway, CA 92064

(760) 814-8050

Provider ID: 212731

License: A55117

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish,

Taiwanese

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Wang, Anchi MD

15611 Pomerado Rd Ste 505

Poway, CA 92064

(760) 630-3000

Provider ID: 257234

License: A79381

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Mandarin,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 441

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Wang, Chunyang MD

15611 Pomerado Rd Ste 505

Poway, CA 92064

(760) 631-3000

Provider ID: 253008

License: A105660

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Mandarin,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92111

Rim, Choon MD

7825 Engineer Rd Ste 101

San Diego, CA 92111

(858) 277-7111

Provider ID: 126693

License: C50815

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Korean,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92121

Calzada, Audrey MD

5405 Oberlin Dr

San Diego, CA 92121

(858) 909-0770

Provider ID: 275301

License: A107965

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Mehta, Ritvik MD

5405 Oberlin Dr Fl 2

San Diego, CA 92121

(858) 909-0770

Provider ID: 257240

License: A93336

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Gujarati,

Hindi

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Obstetrics / Gynecology

CHULA VISTA

91911

Anguiano, Francisco MD

765 Medical Center Ct Ste 209

Chula Vista, CA 91911

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 442

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

(619) 427-8892

Provider ID: 241992

License: G61584

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

CORONADO

92118

Sefa-boakye, Kofi MD

230 Prospect Pl Ste 210

Coronado, CA 92118

(619) 435-0041

Provider ID: 209740

License: G59670

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

EL CAJON

92020

Tajran, Deena MD

291 E Lexington Ave # Ac

El Cajon, CA 92020

(858) 578-9600

Provider ID: 204960

License: A55154

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Arabic

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ENCINITAS

92024

Juma, Saad MD

320 Santa Fe Dr Ste 108

Encinitas, CA 92024

(760) 753-8373

Provider ID: 127805

License: A42398

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA JOLLA

92037

Kurtulus, Mel MD

9850 Genesee Ave Ste 770

La Jolla, CA 92037

(858) 677-0777

Provider ID: 240578

License: A72728

Credentials and/or board

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 443

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Turkish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Spring Robinson, Chandra DO

9850 Genesee Ave Ste 770

La Jolla, CA 92037

(858) 677-0777

Provider ID: 245612

License: 20A17561

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

NATIONAL CITY

91950

Aslian, Azita MD

2400 E 8th St

National City, CA 91950

(619) 662-4100

Provider ID: 253065

License: A118227

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Fataleka

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Del Rosario, Gelen MD

502 Euclid Ave Ste 300

National City, CA 91950

(619) 475-1261

Provider ID: 218345

License: A113471

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

OCEANSIDE

92056

Ebrahimi Adib, Tannaz MD

3927 Waring Rd Ste D

Oceanside, CA 92056

(760) 990-7585

Provider ID: 268667

License: A121761

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Persian

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 444

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

is limited access or when

accessibility indicators are not

present.

Mazarei, Rahele MD

3998 Vista Way Ste C

Oceanside, CA 92056

(760) 941-1440

Provider ID: 279184

License: 20A7358

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Suntay, Berk MD

3998 Vista Way Ste C

Oceanside, CA 92056

(760) 941-1440

Provider ID: 279098

License: A124008

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92114

Sefa-boakye, Kofi MD

286 Euclid Ave Ste 205

San Diego, CA 92114

(619) 263-6141

Provider ID: 209741

License: G59670

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: NR

Accessibility: B, W; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92123

Mansour, Anmar MD

7695 Cardinal Ct Ste 370

San Diego, CA 92123

(858) 277-1599

Provider ID: 215785

License: A92470

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Arabic,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92126

Tajran, Deena MD

10737 Camino Ruiz Ste 114

San Diego, CA 92126

(858) 578-9600

Provider ID: 204961

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 445

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

License: A55154

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

92173

Jenkins, Enchanta MD

4050 Beyer Blvd

San Diego, CA 92173

(619) 662-4100

Provider ID: 269687

License: C143625

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN YSIDRO

92173

Carr, Mianda MD

4004 Beyer Blvd

San Ysidro, CA 92173

(619) 662-4100

Provider ID: 269478

License: A104660

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Goldstein, Edward MD

4050 Beyer Blvd

San Ysidro, CA 92173

(619) 662-4100

Provider ID: 244759

License: G20087

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Mccullough, Deirdre MD

4050 Beyer Blvd

San Ysidro, CA 92173

(619) 662-4100

Provider ID: 269677

License: C159758

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 446

Page 469: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

present.

Sefa-boakye, Kofi MD

4004 Beyer Blvd

San Ysidro, CA 92173

(619) 662-4100

Provider ID: 265323

License: G59670

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Westermann, Melissa MD

4050 Beyer Blvd

San Ysidro, CA 92173

(619) 662-4100

Provider ID: 245878

License: A130149

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Oncology Medical

ENCINITAS

92024

Bessudo, Alberto MD

326 Santa Fe Dr Ste 105

Encinitas, CA 92024

(760) 452-3340

Provider ID: 273486

License: A50309

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Hebrew,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Frakes, Laurie MD

326 Santa Fe Dr Ste 105

Encinitas, CA 92024

(760) 452-3340

Provider ID: 273454

License: A52663

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Flores, Edna MD

326 Santa Fe Dr Ste 105

Encinitas, CA 92024

(760) 452-3340

Provider ID: 273539

License: A114373

Credentials and/or board

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 447

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Mcclay, Edward MD

326 Santa Fe Dr Ste 105

Encinitas, CA 92024

(760) 452-3340

Provider ID: 276710

License: G64594

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Mcclay, Edward MD

477 N El Camino Real Ste D200

Encinitas, CA 92024

(760) 452-3340

Provider ID: 54083

License: G64594

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA JOLLA

92037

Flores, Edna MD

9850 Genesee Ave Ste 560

La Jolla, CA 92037

(858) 552-1410

Provider ID: 273538

License: A114373

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN DIEGO

92127

Eisenberg, Steven DO

16918 Dove Canyon Rd Ste

103

San Diego, CA 92127

(858) 649-5100

Provider ID: 257270

License: 20A8293

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 448

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

is limited access or when

accessibility indicators are not

present.

Flores, Edna MD

16918 Dove Canyon Rd Ste

103

San Diego, CA 92127

(858) 649-5100

Provider ID: 115370

License: A114373

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Lamon, Joel MD

16918 Dove Canyon Rd Ste

103

San Diego, CA 92127

(858) 649-5100

Provider ID: 68222

License: G28164

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: French,

German, Spanish, Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

SAN MARCOS

92069

Eisenberg, Steven DO

838 Nordahl Rd Ste 300

San Marcos, CA 92069

(760) 747-8935

Provider ID: 257271

License: 20A8293

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Frakes, Laurie MD

838 Nordahl Rd Ste 300

San Marcos, CA 92069

(760) 747-8935

Provider ID: 273453

License: A52663

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Mcclay, Edward MD

838 Nordahl Rd Ste 300

San Marcos, CA 92069

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 449

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

(760) 747-8935

Provider ID: 276709

License: G64594

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Ophthalmology

ALPINE

91901

Binder, Nicholas MD

1620 Alpine Blvd Ste 117

Alpine, CA 91901

(619) 445-2687

Provider ID: 214259

License: A124698

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Patel, Gitane MD

1620 Alpine Blvd Ste 117

Alpine, CA 91901

(800) 898-2020

Provider ID: 244861

License: A108603

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Arabic,

Gujarati, Spanish, Tagalog,

Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

CHULA VISTA

91910

Bryant, Duane MD

342 F St

Chula Vista, CA 91910

(619) 422-1471

Provider ID: 212675

License: C155562

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Castillejos-rios, David MD

342 F St

Chula Vista, CA 91910

(619) 422-1471

Provider ID: 202144

License: A44482

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 450

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

PTA: No 342 F St Other Language: Arabic,

Cultural Competency: NR Chula Vista, CA 91910 Korean, Mandarin, Spanish

Accessibility: B; Members (619) 422-1471 Cultural Competency: NR

should call the provider’s Provider ID: 265217 Accessibility: B; Members

office to discuss their License: A154697 should call the provider’s

accessibility needs when there Credentials and/or board office to discuss their

is limited access or when certification: No accessibility needs when there

accessibility indicators are not Accepting New Members: Yes is limited access or when

present. Hours: M-SA 9AM-5PM accessibility indicators are not

PTA: No present.

Other Language: Arabic

Castillejos, Maria MD Cultural Competency: NR

342 F St Accessibility: B; Members Carraby, Arnett MD

Chula Vista, CA 91910 should call the provider’s 835 Third Ave Ste A

(619) 422-1471 office to discuss their Chula Vista, CA 91911

Provider ID: 127777 accessibility needs when there (619) 425-7755

License: A37652 is limited access or when Provider ID: 212807

Credentials and/or board accessibility indicators are not License: G47836

certification: Yes present. Credentials and/or board

Accepting New Members: Yes certification: Yes

Hours: M-SA 9AM-5PM 91911 Accepting New Members: Yes

PTA: No Hours: M-SA 9AM-5PM

Other Language: Spanish Abdallah, Walid MD PTA: No

Cultural Competency: NR 835 Third Ave Ste A Other Language: Spanish,

Accessibility: B; Members Chula Vista, CA 91911 Tagalog, Vietnamese

should call the provider’s (619) 425-7755 Cultural Competency: NR

office to discuss their Provider ID: 269257 Accessibility: B; Members

accessibility needs when there License: A146829 should call the provider’s

is limited access or when Credentials and/or board office to discuss their

accessibility indicators are not certification: No accessibility needs when there

present. Accepting New Members: Yes is limited access or when

Hours: M-SA 9AM-5PM accessibility indicators are not

PTA: No present.

Zabaneh, Alexander MD

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 451

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Other Language: Farsi,

Chavez, Cesar MD French, Spanish, Tagalog,

835 Third Ave Ste A Vietnamese Mani, Majid MD

Chula Vista, CA 91911 Cultural Competency: NR 835 3rd Ave Ste A

(619) 425-7755 Accessibility: B; Members Chula Vista, CA 91911

Provider ID: 246267 should call the provider’s (619) 425-7755

License: G51615 office to discuss their Provider ID: 26922

Credentials and/or board accessibility needs when there License: A60640

certification: No is limited access or when Credentials and/or board

Accepting New Members: Yes accessibility indicators are not certification: No

Hours: M-SA 9AM-5PM present. Accepting New Members: Yes

PTA: No Hours: M-SA 9AM-5PM

Other Language: Spanish PTA: No

Cultural Competency: NR Khandan, Sara MD Other Language: Farsi,

Accessibility: B; Members 835 Third Ave Ste A Spanish

should call the provider’s Chula Vista, CA 91911 Cultural Competency: NR

office to discuss their (619) 425-7755 Accessibility: B; Members

accessibility needs when there Provider ID: 269742 should call the provider’s

is limited access or when License: A155828 office to discuss their

accessibility indicators are not Credentials and/or board accessibility needs when there

present. certification: No is limited access or when

Accepting New Members: Yes accessibility indicators are not

Hours: M-SA 9AM-5PM present.

Delengocky, Tayson DO PTA: No

835 3rd Ave Ste A Other Language: Farsi,

Chula Vista, CA 91911 Spanish Mani, Nasrin MD

(619) 425-7755 Cultural Competency: NR 835 3rd Ave Ste A

Provider ID: 78153 Accessibility: B; Members Chula Vista, CA 91911

License: 20A12784 should call the provider’s (619) 425-7755

Credentials and/or board office to discuss their Provider ID: 27356

certification: Yes accessibility needs when there License: A40473

Accepting New Members: Yes is limited access or when Credentials and/or board

Hours: M-SA 9AM-5PM accessibility indicators are not certification: No

PTA: Yes present. Accepting New Members: Yes

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 452

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Arabic,

Faroese, Farsi, Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Montgomery, Gordon MD

835 3rd Ave Ste A

Chula Vista, CA 91911

(619) 425-7755

Provider ID: 272246

License: G31591

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Korean,

Spanish, Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Moss, Jason MD

835 Third Ave Ste A

Chula Vista, CA 91911

(619) 425-7755

Provider ID: 106478

License: A130529

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Papastergiou, Georgios MD

835 3rd Ave Ste A

Chula Vista, CA 91911

(619) 425-7755

Provider ID: 80983

License: A127706

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Arabic,

Farsi, French, Greek, Italian,

Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Pons, Mauricio MD

835 3rd Ave Ste A

Chula Vista, CA 91911

(619) 425-7755

Provider ID: 23410

License: A87650

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 453

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

present. Accepting New Members: Yes accessibility indicators are not

Hours: M-SA 9AM-5PM present.

PTA: No

Peairs, James MD Other Language: Arabic,

835 Third Ave Ste A Russian, Spanish, Tagalog Skaf, Ayham MD

Chula Vista, CA 91911 Cultural Competency: NR 835 3rd Ave Ste A

(619) 425-7755 Accessibility: B; Members Chula Vista, CA 91911

Provider ID: 212798 should call the provider’s (619) 425-7755

License: A155296 office to discuss their Provider ID: 63195

Credentials and/or board accessibility needs when there License: A120584

certification: No is limited access or when Credentials and/or board

Accepting New Members: Yes accessibility indicators are not certification: No

Hours: M-SA 9AM-5PM present. Accepting New Members: Yes

PTA: No Hours: M-SA 9AM-5PM

Other Language: Arabic, PTA: No

Spanish Sassani, Patrick MD Other Language: Arabic,

Cultural Competency: NR 835 Third Ave Ste A Spanish

Accessibility: B; Members Chula Vista, CA 91911 Cultural Competency: NR

should call the provider’s (619) 425-7755 Accessibility: B; Members

office to discuss their Provider ID: 130013 should call the provider’s

accessibility needs when there License: A150205 office to discuss their

is limited access or when Credentials and/or board accessibility needs when there

accessibility indicators are not certification: No is limited access or when

present. Accepting New Members: Yes accessibility indicators are not

Hours: M-SA 9AM-5PM present.

PTA: No

Rajsbaum, Martin MD Other Language: Arabic,

835 Third Ave Ste A Spanish, Tagalog Stainer, Gregory MD

Chula Vista, CA 91911 Cultural Competency: NR 835 Third Ave Ste A

(619) 425-7755 Accessibility: B; Members Chula Vista, CA 91911

Provider ID: 117787 should call the provider’s (619) 425-7755

License: A42670 office to discuss their Provider ID: 269696

Credentials and/or board accessibility needs when there License: G41135

certification: No is limited access or when Credentials and/or board

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 454

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

EL CAJON

92020

Boeckmann, Jessica MD

450 Fletcher Pkwy

El Cajon, CA 92020

(619) 440-5400

Provider ID: 214427

License: A124361

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Armenian, Cantonese,

French, Mandarin, Spanish,

Tagalog, Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Special Expertise: HIV/AIDS,

Blindness or Visual Impairment

Hsu, Christopher MD

225 W Madison Ave Ste 1

El Cajon, CA 92020

(800) 898-2020

Provider ID: 279228

License: A65973

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Chinese,

Mandarin, Spanish,

Taiwanese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Learn, Richard MD

225 W Madison Ave Ste 1

El Cajon, CA 92020

(800) 898-2020

Provider ID: 279243

License: A19818

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Miller, Douglas MD

450 Fletcher Pkwy Ste 112

El Cajon, CA 92020

(800) 898-2020

Provider ID: 244937

License: G52627

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Tagalog, Vietnamese

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 455

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Patel, Gitane MD

450 Fletcher Pkwy Ste 112

El Cajon, CA 92020

(800) 898-2020

Provider ID: 244862

License: A108603

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Arabic,

Gujarati, Spanish, Tagalog,

Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Patel, Sarjan MD

450 Fletcher Pkwy Ste 112

El Cajon, CA 92020

(800) 898-2020

Provider ID: 244916

License: A114976

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Gujarati,

Hindi, Spanish, Tagalog,

Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Prabhu, Sujata MD

450 Fletcher Pkwy Ste 112

El Cajon, CA 92020

(800) 898-2020

Provider ID: 244911

License: A115965

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish,

Tagalog, Telugu, Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ENCINITAS

92024

Crosby, Michelle MD

477 N El Camino Real Ste C202

Encinitas, CA 92024

(760) 257-5550

Provider ID: 85965

License: A108687

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 456

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SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

Culotta, Anthony MD

320 Santa Fe Dr Ste 104

Encinitas, CA 92024

(800) 898-2020

Provider ID: 268887

License: A97142

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Special Expertise: Deafness or

Hard-of-Hearing, Co-occuring

Disorders

Scotti, Frank MD

320 Santa Fe Dr Ste 104

Encinitas, CA 92024

(760) 943-7141

Provider ID: 244904

License: G40698

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish,

Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

ESCONDIDO

92025

Hudson, Henry MD

830 W Valley Pkwy Ste 300

Escondido, CA 92025

(800) 898-2020

Provider ID: 279226

License: G76091

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Morrison-reyes, Joshua MD

830 W Valley Pkwy Ste 300

Escondido, CA 92025

(760) 743-5872

Provider ID: 275515

License: A125435

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Armenian,

Cantonese, Indonesian,

Mandarin, Spanish, Tagalog,

Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA JOLLA

92037

Alborzian, Shervin MD

9834 Genesee Ave Ste 209

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 457

Page 480: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

La Jolla, CA 92037 should call the provider’s License: A97142

(858) 457-2220 office to discuss their Credentials and/or board

Provider ID: 77720 accessibility needs when there certification: No

License: A107093 is limited access or when Accepting New Members: Yes

Credentials and/or board accessibility indicators are not Hours: M-SA 9AM-5PM

certification: No present. PTA: No

Accepting New Members: Yes Cultural Competency: NR

Hours: M-SA 9AM-5PM Accessibility: B; Members

PTA: No Coden, Daniel MD should call the provider’s

Other Language: Farsi, 9850 Genesee Ave Ste 310 office to discuss their

Spanish La Jolla, CA 92037 accessibility needs when there

Cultural Competency: NR (800) 898-2020 is limited access or when

Accessibility: B; Members Provider ID: 204681 accessibility indicators are not

should call the provider’s License: G57587 present.

office to discuss their Credentials and/or board Special Expertise: Deafness or

accessibility needs when there certification: Yes Hard-of-Hearing, Co-occuring

is limited access or when Accepting New Members: Yes Disorders

accessibility indicators are not Hours: M-SA 9AM-5PM

present. PTA: Yes

Cultural Competency: NR Gollogly, Heidrun MD

Accessibility: B; Members 9850 Genesee Ave Ste 310

Avallone, Thomas MD should call the provider’s La Jolla, CA 92037

9850 Genesee Ave Ste 310 office to discuss their (800) 898-2020

La Jolla, CA 92037 accessibility needs when there Provider ID: 275454

(800) 898-2020 is limited access or when License: A134761

Provider ID: 275499 accessibility indicators are not Credentials and/or board

License: A147199 present. certification: No

Credentials and/or board Accepting New Members: Yes

certification: No Hours: M-SA 9AM-5PM

Accepting New Members: Yes Culotta, Anthony MD PTA: No

Hours: M-SA 9AM-5PM 9834 Genesee Ave Other Language: French,

PTA: No La Jolla, CA 92037 German, Spanish

Cultural Competency: NR (800) 898-2020 Cultural Competency: NR

Accessibility: B; Members Provider ID: 268888 Accessibility: B; Members

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 458

Page 481: 2021 Direktoryo ng Provider at Parmasya Blue Shield

SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Hudson, Henry MD

9850 Genesee Ave Ste 310

La Jolla, CA 92037

(800) 898-2020

Provider ID: 279227

License: G76091

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Morrison-reyes, Joshua MD

9850 Genesee Ave Ste 310

La Jolla, CA 92037

(858) 457-3010

Provider ID: 275517

License: A125435

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Armenian,

Cantonese, Indonesian,

Mandarin, Spanish, Tagalog,

Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Perry, Arthur MD

9850 Genesee Ave Ste 310

La Jolla, CA 92037

(858) 457-3010

Provider ID: 66369

License: C37934

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish,

Tagalog

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

Pratt, Steven MD

9850 Genesee Ave Ste 310

La Jolla, CA 92037

(800) 898-2020

Provider ID: 54350

License: G32379

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Spanish,

Tagalog, Vietnamese

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

LA MESA

(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse

midwives CNS: Certified Nurse Specialists

Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only

Call Member Services if you need information about a provider’s other credentials and/or certifications,

completion of cultural competence training, and/or areas of training and experience. This list is subject to

change 459

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