h0148 20 141 pno la dec vi 2020 - blue shield of california€¦ · h0148_20_141_pno_la_dec_vi blue...
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H0148_20_141_PNO_LA_DEC_VI
Blue Shield Promise Cal MediConnect Plan
(Medicare-Medicaid Plan)
2020
: Los Angeles
Tháng MườI Hai
Tháng MườI Hai 2019
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Danh sách các nhà cung cấp mạng....................................................................................1
ALLIED PHYSICIANS IPA OF CA DBA ALLIED PACIFIC IPA
Bác sĩ chăm sóc chính ........................................................................................................1
Chuyên gia ..........................................................................................................................3
ALTAMED - MONTEREY PARK
Bác sĩ chăm sóc chính ........................................................................................................6
Chuyên gia ..........................................................................................................................6
ALTAMED HEALTH SERVICES CORPORATION
Bác sĩ chăm sóc chính ........................................................................................................8
Chuyên gia ..........................................................................................................................11
ANGELES IPA
Bác sĩ chăm sóc chính ........................................................................................................19
Chuyên gia ..........................................................................................................................20
APPLECARE MEDICAL GROUP- DOWNEY
Bác sĩ chăm sóc chính ........................................................................................................22
APPLECARE MEDICAL GROUP- SELECT
Bác sĩ chăm sóc chính ........................................................................................................24
APPLECARE MEDICAL GROUP- WHITTIER
Bác sĩ chăm sóc chính ........................................................................................................26
APPLECARE MEDICAL GROUP-ST FRANCIS
Bác sĩ chăm sóc chính ........................................................................................................27
COMMUNITY FAMILY CARE - VALLEY PRES
Chuyên gia ..........................................................................................................................29
FAMILY CARE SPECIALIST IPA
Chuyên gia ..........................................................................................................................30
HEALTH CARE LA IPA
Bác sĩ chăm sóc chính ........................................................................................................32
Chuyên gia ..........................................................................................................................33
HEALTHCARE PARTNERS
Bác sĩ chăm sóc chính ........................................................................................................57
Chuyên gia ..........................................................................................................................57
HEALTHCARE PARTNERS IPA - ARCADIA
Chuyên gia ..........................................................................................................................63
HEALTHCARE PARTNERS IPA - EAST WEST
Bác sĩ chăm sóc chính ........................................................................................................64
HEALTHCARE PARTNERS IPA - GLENDALE
I
Nếu quý vị có thắc mắc, vui lòng gọi Blue Shield Promise Cal MediConnect Plan theo số1-855-905-3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. bảy ngày mỗi tuần. Cuộc gọi được miễn phí. Để tìmhiểu thêm, truy cập www.blueshieldca.com/promise/calmediconnect.
Mục lục
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Chuyên gia ..........................................................................................................................66
HEALTHCARE PARTNERS IPA - LAC
Bác sĩ chăm sóc chính ........................................................................................................68
HEALTHCARE PARTNERS IPA - LCM
Bác sĩ chăm sóc chính ........................................................................................................69
Chuyên gia ..........................................................................................................................69
HEALTHCARE PARTNERS IPA - LONG BEACH
Bác sĩ chăm sóc chính ........................................................................................................72
Chuyên gia ..........................................................................................................................73
HEALTHCARE PARTNERS IPA - NORTHRIDGE MEDICAL GROUP
Bác sĩ chăm sóc chính ........................................................................................................75
Chuyên gia ..........................................................................................................................75
HEALTHCARE PARTNERS IPA - PASADENA
Chuyên gia ..........................................................................................................................77
HEALTHCARE PARTNERS IPA - SO BAY
Bác sĩ chăm sóc chính ........................................................................................................78
Chuyên gia ..........................................................................................................................78
HEALTHCARE PARTNERS IPA-HILLCREST
Chuyên gia ..........................................................................................................................81
HEALTHCARE PARTNERS IPA-TALBERT LA
Bác sĩ chăm sóc chính ........................................................................................................82
HEALTHCARE PARTNERS IPA-TALBERT OC
Bác sĩ chăm sóc chính ........................................................................................................83
Chuyên gia ..........................................................................................................................83
HEALTHCARE PARTNERS IPA-TORRANCE
Chuyên gia ..........................................................................................................................85
HEALTHCARE PARTNERS MEDICAL GROUP - ALHAMBRA
Chuyên gia ..........................................................................................................................87
HEALTHCARE PARTNERS MEDICAL GROUP - ARCADIA
Bác sĩ chăm sóc chính ........................................................................................................88
HEALTHCARE PARTNERS MEDICAL GROUP - ATLANTIC
Chuyên gia ..........................................................................................................................89
HEALTHCARE PARTNERS MEDICAL GROUP - CARSON
Chuyên gia ..........................................................................................................................90
HEALTHCARE PARTNERS MEDICAL GROUP - DEL AMO
Chuyên gia ..........................................................................................................................91
HEALTHCARE PARTNERS MEDICAL GROUP - ELA
Chuyên gia ..........................................................................................................................92
HEALTHCARE PARTNERS MEDICAL GROUP - GLEN OAKS
II
Nếu quý vị có thắc mắc, vui lòng gọi Blue Shield Promise Cal MediConnect Plan theo số1-855-905-3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. bảy ngày mỗi tuần. Cuộc gọi được miễn phí. Để tìmhiểu thêm, truy cập www.blueshieldca.com/promise/calmediconnect.
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Chuyên gia ..........................................................................................................................93
HEALTHCARE PARTNERS MEDICAL GROUP - GLENDALE
Chuyên gia ..........................................................................................................................94
HEALTHCARE PARTNERS MEDICAL GROUP - GLENDORA
Chuyên gia ..........................................................................................................................96
HEALTHCARE PARTNERS MEDICAL GROUP - MAGAN
Bác sĩ chăm sóc chính ........................................................................................................97
HEALTHCARE PARTNERS MEDICAL GROUP - MANHATTAN BEACH
Chuyên gia ..........................................................................................................................98
HEALTHCARE PARTNERS MEDICAL GROUP - MONROVIA
Chuyên gia ..........................................................................................................................99
HEALTHCARE PARTNERS MEDICAL GROUP - PASADENA MAIN
Chuyên gia ..........................................................................................................................100
HEALTHCARE PARTNERS MEDICAL GROUP - REDONDO BEACH
Chuyên gia ..........................................................................................................................101
HEALTHCARE PARTNERS MEDICAL GROUP - SEPULVEDA
Chuyên gia ..........................................................................................................................102
HEALTHCARE PARTNERS MEDICAL GROUP - SPRING ST
Chuyên gia ..........................................................................................................................103
HEALTHCARE PARTNERS MEDICAL GROUP - TEMPLE CITY
Chuyên gia ..........................................................................................................................104
HEALTHCARE PARTNERS MEDICAL GROUP - WILLOW
Chuyên gia ..........................................................................................................................105
HEALTHCARE PARTNERS MEDICAL GROUP- BIXBY KNOLLS LONG BEACH
Chuyên gia ..........................................................................................................................106
HEALTHCARE PARTNERS MEDICAL GROUP- VANOWEN
Chuyên gia ..........................................................................................................................107
HEALTHCARE PARTNERS MEDICAL GROUP-LAKEWOOD
Chuyên gia ..........................................................................................................................109
HEALTHCARE PARTNERS MEDICAL GROUP-SAN ANTONIO
Chuyên gia ..........................................................................................................................110
HEALTHCARE PARTNERS MEDICAL GROUP-SANTA ANITA/SAN GABRIEL
Chuyên gia ..........................................................................................................................112
HEALTHCARE PARTNTERS MEDICAL GROUP - DEL MAR
Chuyên gia ..........................................................................................................................113
HEALTHCARE PARTNTERS MEDICAL GROUP - VERDUGO
Chuyên gia ..........................................................................................................................114
KOREAN AMERICAN MEDICAL GROUP
Chuyên gia ..........................................................................................................................115
III
Nếu quý vị có thắc mắc, vui lòng gọi Blue Shield Promise Cal MediConnect Plan theo số1-855-905-3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. bảy ngày mỗi tuần. Cuộc gọi được miễn phí. Để tìmhiểu thêm, truy cập www.blueshieldca.com/promise/calmediconnect.
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LOS ANGELES MEDICAL CENTER IPA
Bác sĩ chăm sóc chính ........................................................................................................116
Chuyên gia ..........................................................................................................................116
PHYSICIANS ASSOC SAN GABRIEL VALLEY
Bác sĩ chăm sóc chính ........................................................................................................118
PREFERRED IPA OF CALIFORNIA
Bác sĩ chăm sóc chính ........................................................................................................120
PRIMARY CARE ASSOCIATES OF CALIFORNIA
Bác sĩ chăm sóc chính ........................................................................................................122
Chuyên gia ..........................................................................................................................123
PROSPECT HEALTHSOURCE MEDICAL GROUP
Chuyên gia ..........................................................................................................................125
PROSPECT MEDICAL GROUP-LOS ANGELES
Bác sĩ chăm sóc chính ........................................................................................................127
Chuyên gia ..........................................................................................................................127
PROSPECT MEDICAL GROUP-VAN NUYS
Chuyên gia ..........................................................................................................................135
PROSPECT NWOC MEDICAL GROUP-LA
Chuyên gia ..........................................................................................................................137
PROSPECT PROFESSIONAL CARE MED GRP LA
Bác sĩ chăm sóc chính ........................................................................................................140
Chuyên gia ..........................................................................................................................141
PROSPECT-NUESTRA FAMILIA MEDICAL GROUP
Bác sĩ chăm sóc chính ........................................................................................................148
Chuyên gia ..........................................................................................................................148
PROSPECT-SAN MIGUEL IPA
Chuyên gia ..........................................................................................................................153
SEOUL MEDICAL GROUP
Chuyên gia ..........................................................................................................................154
TORRANCE HEALTH IPA
Bác sĩ chăm sóc chính ........................................................................................................159
Chuyên gia ..........................................................................................................................159
Châm cứu............................................................................................................................161
Nhà cung cấp sức khỏe tâm thần .......................................................................................235
Nhà cung cấp tầm nhìn .......................................................................................................297
Cơ sở sức khỏe tâm thần ...................................................................................................358
Chỉ số nhà cung cấp ...........................................................................................................361
Chỉ số nhà thuốc .................................................................................................................367
IV
Nếu quý vị có thắc mắc, vui lòng gọi Blue Shield Promise Cal MediConnect Plan theo số1-855-905-3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. bảy ngày mỗi tuần. Cuộc gọi được miễn phí. Để tìmhiểu thêm, truy cập www.blueshieldca.com/promise/calmediconnect.
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V
Nếu quý vị có thắc mắc, vui lòng gọi Blue Shield Promise Cal MediConnect Plan theo số1-855-905-3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. bảy ngày mỗi tuần. Cuộc gọi được miễn phí. Để tìmhiểu thêm, truy cập www.blueshieldca.com/promise/calmediconnect.
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LOS ANGELES COUNTY MEDICAL GROUPSALLIED PHYSICIANS IPA OF CA DBA ALLIED PACIFIC IPA
PRIMARY CARE PHYSICIANS
Family Practice
BALDWIN PARK
91706
Urbina, Marvin MD
14342 Ramona Blvd
Baldwin Park, CA 91706
(626) 918-3828
Provider ID: 209601
License: A71133
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.
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
DIAMOND BAR
91765
Chen, David MD
2705 S Diamond Bar Blvd Ste
100
Diamond Bar, CA 91765
(626) 965-1988
Provider ID: 240691
License: A82411
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: 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.
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
General Practice
BALDWIN PARK
91706
Carrillo, Herman MD
14342 Ramona Blvd
Baldwin Park, CA 91706
(626) 918-3828
Provider ID: 210188
License: A45086
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.
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
BURBANK
91501
Lee, Philip DO
421 E Angeleno Ave # 10
Burbank, CA 91501
(818) 845-6800
(*) 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 1
-
LOS ANGELES COUNTY MEDICAL GROUPSALLIED PHYSICIANS IPA OF CA DBA ALLIED PACIFIC IPA
Provider ID: 243649
License: 20A3502
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Armenian, Cantonese,
Chinese, Indonesian,
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.
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
ROSEMEAD
91770
Hanson, Lars MD
8811 Garvey Ave Ste 101
Rosemead, CA 91770
(626) 260-8801
Provider ID: 70366
License: G79925
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Cantonese,
Mandarin, 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.
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
Internal Medicine
EL MONTE
91731
Jaffe, Robert MD
Effective as of 1/1/2020
3564 Santa Anita Ave Ste A
El Monte, CA 91731
(626) 350-8101
Provider ID: 245165
License: G34013
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Bengali,
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.
UPDATE: NEW Provider Added.
Effective_Date: 04-NOV-19
HACIENDA HEIGHTS
91745
Song, James MD
16404 Colima Rd Fl 1
Hacienda Heights, CA 91745
(626) 581-7603
Provider ID: 87167
License: G75661
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Cantonese,
Chinese, Mandarin, 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 2
-
LOS ANGELES COUNTY MEDICAL GROUPSALLIED PHYSICIANS IPA OF CA DBA ALLIED PACIFIC IPA
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
ROWLAND HEIGHTS
91748
Hussain, Rizwana MD
18750 Colima Rd Ste B
Rowland Heights, CA 91748
(626) 912-9345
Provider ID: 82308
License: A38923
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Hindi,
Spanish, Tagalog, Urdu
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.
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
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.
Gastroenterology
MONTEREY PARK
91754
Lai, Chia Chi MD
500 N Garfield Ave Ste 100
Monterey Park, CA 91754
(626) 280-5009
Provider ID: 5796
License: A42437
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Cantonese,
Chinese, Spanish, Taiwanese,
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.
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
Ophthalmology
BEVERLY HILLS
90211
Abdallah, Walid MD
9001 Wilshire Blvd Ste 301
Beverly Hills, CA 90211
(213) 202-5890
Provider ID: 240207
License: A146829
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
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’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
-
LOS ANGELES COUNTY MEDICAL GROUPSALLIED PHYSICIANS IPA OF CA DBA ALLIED PACIFIC IPA
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
LONG BEACH
90808
Grant-acquah, Kweku MD
3816 Woodruff Ave Ste 100
Long Beach, CA 90808
(800) 898-2020
Provider ID: 102864
License: A126202
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Armenian,
Cantonese, Farsi, 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.
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
LOS ANGELES
90031
Morrison-reyes, Joshua MD
2400 N Broadway
Los Angeles, CA 90031
(800) 898-2020
Provider ID: 100805
License: A125435
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Armenian,
Indonesian, 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.
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
PASADENA
91105
Morrison-reyes, Joshua MD
100 E California Blvd
Pasadena, CA 91105
(800) 898-2020
Provider ID: 88024
License: A125435
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Armenian,
Indonesian, 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.
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
Samuel, Michael MD
100 E California Blvd
Pasadena, CA 91105
(800) 898-2020
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’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
-
LOS ANGELES COUNTY MEDICAL GROUPSALLIED PHYSICIANS IPA OF CA DBA ALLIED PACIFIC IPA
Provider ID: 88020
License: A83237
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.
Special Expertise: Deafness or
Hard-of-Hearing, Co-occuring
Disorders
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’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
-
LOS ANGELES COUNTY MEDICAL GROUPSALTAMED - MONTEREY PARK
PRIMARY CARE PHYSICIANS
Family Practice
COMMERCE
90022
Granados, Michael MD
Effective as of 1/1/2020
5427 Whittier Blvd
Commerce, CA 90022
(888) 499-9303
Provider ID: 244517
License: A145680
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.
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
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.
Gastroenterology
MONTEBELLO
90640
Alaama, Abdul MD
101 E Beverly Blvd Ste 204
Montebello, CA 90640
(323) 728-8009
Provider ID: 91562
License: A25455
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, 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.
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
Optometrist
HUNTINGTON PARK
90255
Perez, Evelyn OD
2715 E Florence Ave
Huntington Park, CA 90255
(323) 581-0120
Provider ID: 244077
License: OPT10155
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
UPDATE: NEW Provider Added.
Effective_Date: 13-NOV-19
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’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
-
LOS ANGELES COUNTY MEDICAL GROUPSALTAMED - MONTEREY PARK
LOS ANGELES
90057
Perez, Evelyn OD
139 S Alvarado St
Los Angeles, CA 90057
(213) 484-0170
Provider ID: 244074
License: OPT10155
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
Physicians Assistant
90011
Sanchez, Teresa PA
2801 S San Pedro St
Los Angeles, CA 90011
(323) 233-3100
Provider ID: 244329
License: PA23002
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
Surgery General
MONTEREY PARK
91754
Gelvezon, Nani DO
600 N Garfield Ave Ste 210
Monterey Park, CA 91754
(626) 537-8282
Provider ID: 244931
License: 20A11327
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’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
-
LOS ANGELES COUNTY MEDICAL GROUPSALTAMED HEALTH SERVICES CORPORATION
PRIMARY CARE PHYSICIANS
Family Practice
BALDWIN PARK
91706
Doan, Hung MD
4126 Maine Ave
Baldwin Park, CA 91706
(323) 724-0019
Provider ID: 215763
License: A45781
Credentials and/or board
certification: No
Accepting New Members: No
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.
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
Urbina, Marvin MD
14342 Ramona Blvd
Baldwin Park, CA 91706
(626) 918-3828
Provider ID: 109128
License: A71133
Credentials and/or board
certification: No
Accepting New Members: No
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.
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
COMMERCE
90022
Granados, Michael MD
Effective as of 1/1/2020
5427 Whittier Blvd
Commerce, CA 90022
(888) 499-9303
Provider ID: 244516
License: A145680
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.
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
MAYWOOD
90270
Bulaon, Carlos MD
5953 Atlantic Blvd
Maywood, CA 90270
(323) 562-6170
Provider ID: 218161
License: A48343
Credentials and/or board
certification: No
Accepting New Members: No
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 8
-
LOS ANGELES COUNTY MEDICAL GROUPSALTAMED HEALTH SERVICES CORPORATION
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.
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
PARAMOUNT
90723
Mendoza, Manuel MD
16660 Paramount Blvd Ste 306
Paramount, CA 90723
(562) 926-7796
Provider ID: 213556
License: A53896
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.
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
SOUTH GATE
90280
Angulo, Marco MD
Effective as of 1/1/2020
8627 Atlantic Ave
South Gate, CA 90280
(888) 499-9303
Provider ID: 244938
License: A125066
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.
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
General Practice
BALDWIN PARK
91706
Carrillo, Herman MD
14342 Ramona Blvd
Baldwin Park, CA 91706
(626) 918-3828
Provider ID: 109039
License: A45086
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.
UPDATE: There was a change
in the provider record;
demographic, phone and/or
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’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
-
LOS ANGELES COUNTY MEDICAL GROUPSALTAMED HEALTH SERVICES CORPORATION
panel status.
HAWAIIAN GARDENS
90716
Aguiluz, Amable MD
21500 Pioneer Blvd Ste 209
Hawaiian Gardens, CA 90716
(562) 860-2442
Provider ID: 97418
License: A33886
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; 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
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
Internal Medicine
LOS ANGELES
90033
Saadi, Zainab MD
Effective as of 1/1/2020
2219 E 1st St
Los Angeles, CA 90033
(888) 499-9303
Provider ID: 245206
License: A134800
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
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.
UPDATE: NEW Provider Added.
Effective_Date: 12-NOV-19
Saadi, Zainab MD
Effective as of 1/1/2020
2219 E 1st St
Los Angeles, CA 90033
(888) 499-9303
Provider ID: 245206
License: A134800
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
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.
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
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.
Gastroenterology
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’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
-
LOS ANGELES COUNTY MEDICAL GROUPSALTAMED HEALTH SERVICES CORPORATION
MONTEBELLO
90640
Alaama, Abdul MD
101 E Beverly Blvd Ste 204
Montebello, CA 90640
(323) 728-8009
Provider ID: 91562
License: A25455
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, 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.
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
Gynecologic Oncology
LOS ANGELES
90015
Wu, Eijean MD
1513 S Grand Ave Ste 400
Los Angeles, CA 90015
(213) 742-6188
Provider ID: 121801
License: A117540
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.
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
Gynecology
Pak, Marian DO
1513 S Grand Ave Ste 400
Los Angeles, CA 90015
(213) 742-6400
Provider ID: 243499
License: 20A13783
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.
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
Hematology / Oncology
DOWNEY
90241
Gonzalez, Haydee MD
11480 Brookshire Ave Ste 309
Downey, CA 90241
(562) 869-1201
Provider ID: 244872
License: G155495
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 11
-
LOS ANGELES COUNTY MEDICAL GROUPSALTAMED HEALTH SERVICES CORPORATION
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
UPDATE: NEW Provider Added.
Effective_Date: 22-NOV-19
LOS ANGELES
90033
Chand, Arati Rani MD
1701 E Cesar E Chavez Ave
Ste 535
Los Angeles, CA 90033
(323) 284-4077
Provider ID: 217977
License: A121285
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.
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
WEST COVINA
91790
Sakruti, Susmita MD
1135 S Sunset Ave Ste 301
West Covina, CA 91790
(626) 283-5183
Provider ID: 243459
License: A161532
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.
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
Neurology
LONG BEACH
90807
Zardouz, Shawn MD
3620 Atlantic Ave
Long Beach, CA 90807
(562) 595-0060
Provider ID: 243613
License: A131987
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
UPDATE: There was a change
in the provider record;
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’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
-
LOS ANGELES COUNTY MEDICAL GROUPSALTAMED HEALTH SERVICES CORPORATION
demographic, phone and/or
panel status.
Obstetrics / Gynecology
EL MONTE
91731
Pham, Maggie DO
10418 Valley Blvd Ste B
El Monte, CA 91731
(888) 499-9303
Provider ID: 243198
License: 20A17125
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Chinese,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
Zeng, Wanchi MD
10418 Valley Blvd Ste B
El Monte, CA 91731
(884) 999-9303
Provider ID: 243633
License: A150509
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Cantonese,
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.
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
LOS ANGELES
90033
Givens Beckerman, Erica MD
1701 E Cesar E Chavez Ave
Ste 200 And 225
Los Angeles, CA 90033
(323) 225-4300
Provider ID: 118254
License: A150307
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.
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
WEST COVINA
91790
Pham, Maggie DO
1300 S Sunset Ave
West Covina, CA 91790
(888) 499-9303
Provider ID: 243196
License: 20A17125
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 13
-
LOS ANGELES COUNTY MEDICAL GROUPSALTAMED HEALTH SERVICES CORPORATION
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Chinese,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
Pham, Maggie DO
1135 S Sunset Ave Ste 305
West Covina, CA 91790
(626) 593-5129
Provider ID: 243197
License: 20A17125
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Chinese,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
Zeng, Wanchi MD
1135 S Sunset Ave Ste 305
West Covina, CA 91790
(626) 593-5129
Provider ID: 243634
License: A150509
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Cantonese,
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.
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
Zeng, Wanchi MD
1300 S Sunset Ave
West Covina, CA 91790
(888) 499-9303
Provider ID: 243635
License: A150509
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Cantonese,
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.
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
Ophthalmology
TORRANCE
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’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
-
LOS ANGELES COUNTY MEDICAL GROUPSALTAMED HEALTH SERVICES CORPORATION
90503
Gallemore, Ron MD
4201 Torrance Blvd Ste 220
Torrance, CA 90503
(310) 944-9393
Provider ID: 34344
License: G78240
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Armenian,
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.
Special Expertise: HIV/AIDS,
Deafness or Hard-of-Hearing,
Co-occuring Disorders
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
Optometrist
HUNTINGTON PARK
90255
Perez, Evelyn OD
2715 E Florence Ave
Huntington Park, CA 90255
(323) 581-0120
Provider ID: 244078
License: OPT10155
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
UPDATE: NEW Provider Added.
Effective_Date: 13-NOV-19
LOS ANGELES
90037
Rossi Campagna, Victoria OD
3916 S Broadway
Los Angeles, CA 90037
(323) 234-9137
Provider ID: 243305
License: OPT13545
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.
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
90057
Perez, Evelyn OD
139 S Alvarado St
Los Angeles, CA 90057
(213) 484-0170
Provider ID: 244075
License: OPT10155
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 15
-
LOS ANGELES COUNTY MEDICAL GROUPSALTAMED HEALTH SERVICES CORPORATION
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
Otolaryngology
90027
Maki, Ahmed DO
1300 N Vermont Ave Ste 605
Los Angeles, CA 90027
(323) 593-7682
Provider ID: 118634
License: 20A13553
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Armenian, 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.
Special Expertise: Deafness or
Hard-of-Hearing, Co-occuring
Disorders
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
Physicians Assistant
90011
Sanchez, Teresa PA
2801 S San Pedro St
Los Angeles, CA 90011
(323) 233-3100
Provider ID: 244328
License: PA23002
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
Podiatrist
PICO RIVERA
90660
Stern, Alexandria DPM
9436 Slauson Ave
Pico Rivera, CA 90660
(888) 499-9303
Provider ID: 243701
License: DPM5355
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
UPDATE: NEW Provider Added.
Effective_Date: 08-NOV-19
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’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
-
LOS ANGELES COUNTY MEDICAL GROUPSALTAMED HEALTH SERVICES CORPORATION
Radiology Diagnostic X-ray
LOS ANGELES
90024
Golshan, Ali MD
1082 Glendon Ave
Los Angeles, CA 90024
(310) 209-2011
Provider ID: 243194
License: A108102
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.
UPDATE: NEW Provider Added.
Effective_Date: 01-NOV-19
Surgery General
MONTEREY PARK
91754
Gelvezon, Nani DO
600 N Garfield Ave Ste 210
Monterey Park, CA 91754
(626) 537-8282
Provider ID: 244932
License: 20A11327
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
POMONA
91768
Wali, Autar MD
155 W Willow St
Pomona, CA 91768
(909) 868-2626
Provider ID: 3798
License: A32290
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Hindi,
Spanish, Urdu
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.
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
Surgery Hand
LOS ANGELES
90020
Lee, Daniel MD
505 S Virgil Ave Ste 205
Los Angeles, CA 90020
(213) 805-5822
Provider ID: 243320
License: A109759
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 17
-
LOS ANGELES COUNTY MEDICAL GROUPSALTAMED HEALTH SERVICES CORPORATION
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.
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’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
-
LOS ANGELES COUNTY MEDICAL GROUPSANGELES IPA
PRIMARY CARE PHYSICIANS
General Practice
HAWAIIAN GARDENS
90716
Aguiluz, Amable MD
21500 Pioneer Blvd Ste 209
Hawaiian Gardens, CA 90716
(562) 860-2442
Provider ID: 103939
License: A33886
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.
Special Expertise: Deafness or
Hard-of-Hearing, Co-occuring
Disorders
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
HUNTINGTON PARK
90255
Galdamez, Luis MD
6831 Seville Ave
Huntington Park, CA 90255
(323) 585-0732
Provider ID: 22216
License: A48644
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.
Special Expertise: Deafness or
Hard-of-Hearing, Co-occuring
Disorders
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
Herrera, Humberto MD
6831 Seville Ave
Huntington Park, CA 90255
(323) 585-0732
Provider ID: 56696
License: A45967
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.
Special Expertise: Deafness or
Hard-of-Hearing, Co-occuring
Disorders
UPDATE: There was a change
in the provider record;
demographic, phone and/or
panel status.
LONG BEACH
90804
Rouzroch, Siamak MD
1703 Termino Ave Ste 107
Long Beach, CA 90804
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shi