340
H0148_20_141_PNO_LA_MAR_VI_Accepted Date 03/14/2020 2020 Phụ Lục Danh Bạ Nhà Cung cấp & Nhà Thuốc Blue Shield Promise Cal MediConnect Plan (Medicare-Medicaid Plan) Quận: Los Angeles Vui lòng tham khảo Danh Bạ Nhà Cung cấp & Nhà Thuốc năm 2020 của quý vị để biết thông tin quan trọng về chương trình, cũng như danh sách các nhà cung cấp nhà thuốc bổ sung của chương trình Blue Shield Promise Cal MediConnect. Phụ lục này danh sách cập nhật thông tin về nhà cung cấp cho tháng Tháng Ba. Danh bạ nhà cung cấp bản cứng cùng với phụ lục này thông tin cập nhật nhất về nhà cung cấp. Quý vị cũng thể truy cập www.blueshieldca.com/ promise/calmediconnect hoặc gọi Ban Dịch vụ Hội viên Blue Shield Promise Cal MediConnect theo số điện thoại bên dưới để thông tin về nhà cung cấp nhà thuốc. Dịch vụ Hội viên của Blue Shield Promise Cal MediConnect: 1-855-905-3825 (TTY: 711) Từ 8:00 sáng đến 8:00 tối, bảy ngày một tuần Phụ lục này cập nhật từ tháng Tháng Ba 2020. blue® california Promise Health Plan

MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

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Page 1: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

H0148_20_141_PNO_LA_MAR_VI_Accepted Date 03/14/2020

2020Phụ Lục

Danh Bạ Nhà Cung cấp & Nhà Thuốc Blue Shield Promise Cal MediConnect Plan

(Medicare-Medicaid Plan)Quận: Los Angeles

Vui lòng tham khảo Danh Bạ Nhà Cung cấp & Nhà Thuốc năm 2020 của quý vị để biết thông tin quan trọng về chương trình, cũng như danh sách các nhà cung cấp và nhà thuốc bổ sung của chương trình Blue Shield Promise Cal MediConnect. Phụ lục này là danh sách cập nhật thông tin về nhà cung cấp cho tháng Tháng Ba. Danh bạ nhà cung cấp bản cứng cùng với phụ lục này là thông tin cập nhật nhất về nhà cung cấp. Quý vị cũng có thể truy cập www.blueshieldca.com/ promise/calmediconnect hoặc gọi Ban Dịch vụ Hội viên Blue Shield Promise Cal MediConnect theo số điện thoại bên dưới để có thông tin về nhà cung cấp và nhà thuốc.Dịch vụ Hội viên của Blue Shield Promise Cal MediConnect: 1-855-905-3825 (TTY: 711) Từ 8:00 sáng đến 8:00 tối, bảy ngày một tuầnPhụ lục này cập nhật từ tháng Tháng Ba 2020.

blue®california

Promise Health Plan

Page 2: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT
Page 3: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

Mục lục

Danh sách các nhà cung cấp mạng....................................................................................1

ALLIED PHYSICIANS IPA OF CA DBA ALLIED PACIFIC IPA

ALTAMED - MONTEREY PARK

ALTAMED HEALTH SERVICES CORPORATION

ANGELES IPA

APPLECARE MEDICAL GROUP- DOWNEY

APPLECARE MEDICAL GROUP- SELECT

APPLECARE MEDICAL GROUP- WHITTIER

APPLECARE MEDICAL GROUP-ST FRANCIS

COMMUNITY FAMILY CARE - VALLEY PRES

FAMILY CARE SPECIALIST IPA

HEALTH CARE LA IPA

HEALTHCARE PARTNERS

HEALTHCARE PARTNERS IPA - EAST WEST

HEALTHCARE PARTNERS IPA - GLENDALE

Bác sĩ chăm sóc chính ........................................................................................................1

Chuyên gia ..........................................................................................................................4

Chuyên gia ..........................................................................................................................6

Bác sĩ chăm sóc chính ........................................................................................................9

Chuyên gia ..........................................................................................................................11

Bác sĩ chăm sóc chính ........................................................................................................18

Chuyên gia ..........................................................................................................................18

Bác sĩ chăm sóc chính ........................................................................................................21

Bác sĩ chăm sóc chính ........................................................................................................23

Bác sĩ chăm sóc chính ........................................................................................................25

Bác sĩ chăm sóc chính ........................................................................................................27

Bác sĩ chăm sóc chính ........................................................................................................28

Chuyên gia ..........................................................................................................................28

Chuyên gia ..........................................................................................................................30

Bác sĩ chăm sóc chính ........................................................................................................33

Chuyên gia ..........................................................................................................................34

Bác sĩ chăm sóc chính ........................................................................................................57

Chuyên gia ..........................................................................................................................57

Bác sĩ chăm sóc chính ........................................................................................................61

Bác sĩ chăm sóc chính ........................................................................................................62

Chuyên gia ..........................................................................................................................62

Nếu quý vị có thắc mắc, vui lòng gọi Blue Shield Promise Cal MediConnect Plan theo số 1-855-905-3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. bảy ngày mỗi tuần. Cuộc gọi được miễn phí. Để tìm

hiểu thêm, truy cập www.blueshieldca.com/promise/calmediconnect.

I

Page 4: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

HEALTHCARE PARTNERS IPA - LAC

Bác sĩ chăm sóc chính ........................................................................................................64

HEALTHCARE PARTNERS IPA - LCM

Bác sĩ chăm sóc chính ........................................................................................................65

HEALTHCARE PARTNERS IPA - LONG BEACH

Bác sĩ chăm sóc chính ........................................................................................................67

Chuyên gia ..........................................................................................................................67

HEALTHCARE PARTNERS IPA - NORTHRIDGE MEDICAL GROUP

Bác sĩ chăm sóc chính ........................................................................................................69

HEALTHCARE PARTNERS IPA - SFV

Bác sĩ chăm sóc chính ........................................................................................................70

HEALTHCARE PARTNERS IPA - SO BAY

Bác sĩ chăm sóc chính ........................................................................................................71

Chuyên gia ..........................................................................................................................72

HEALTHCARE PARTNERS IPA-TALBERT OC

Bác sĩ chăm sóc chính ........................................................................................................74

HEALTHCARE PARTNERS MEDICAL GROUP - ARCADIA

Bác sĩ chăm sóc chính ........................................................................................................75

HEALTHCARE PARTNERS MEDICAL GROUP - ATLANTIC

Chuyên gia ..........................................................................................................................76

HEALTHCARE PARTNERS MEDICAL GROUP - BURBANK

Chuyên gia ..........................................................................................................................77

HEALTHCARE PARTNERS MEDICAL GROUP - GLENDALE

Chuyên gia ..........................................................................................................................79

HEALTHCARE PARTNERS MEDICAL GROUP - VAN NUYS

Chuyên gia ..........................................................................................................................80

HEALTHCARE PARTNERS MEDICAL GROUP- BIXBY KNOLLS LONG BEACH

Chuyên gia ..........................................................................................................................81

HEALTHCARE PARTNERS MEDICAL GROUP-MAGNOLIA

Chuyên gia ..........................................................................................................................82

KOREAN AMERICAN MEDICAL GROUP

Chuyên gia ..........................................................................................................................83

LOS ANGELES MEDICAL CENTER IPA

Bác sĩ chăm sóc chính ........................................................................................................84

PHYSICIANS ASSOC SAN GABRIEL VALLEY

Bác sĩ chăm sóc chính ........................................................................................................86

PREFERRED IPA OF CALIFORNIA

Bác sĩ chăm sóc chính ........................................................................................................88

Chuyên gia ..........................................................................................................................89

Nếu quý vị có thắc mắc, vui lòng gọi Blue Shield Promise Cal MediConnect Plan theo số 1-855-905-3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. bảy ngày mỗi tuần. Cuộc gọi được miễn phí. Để tìm

hiểu thêm, truy cập www.blueshieldca.com/promise/calmediconnect.

II

Page 5: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

PRIMARY CARE ASSOCIATES OF CALIFORNIA

Bác sĩ chăm sóc chính ........................................................................................................91

PROSPECT HEALTHSOURCE MEDICAL GROUP

PROSPECT MEDICAL GROUP-LOS ANGELES

PROSPECT MEDICAL GROUP-VAN NUYS

PROSPECT NWOC MEDICAL GROUP-LA

PROSPECT PROFESSIONAL CARE MED GRP LA

PROSPECT-DAEHAN

PROSPECT-NUESTRA FAMILIA MEDICAL GROUP

PROSPECT-SAN MIGUEL IPA

SEOUL MEDICAL GROUP

TORRANCE HEALTH IPA

Chuyên gia ..........................................................................................................................92

Chuyên gia ..........................................................................................................................94

Bác sĩ chăm sóc chính ........................................................................................................98

Chuyên gia ..........................................................................................................................98

Chuyên gia ..........................................................................................................................103

Chuyên gia ..........................................................................................................................106

Bác sĩ chăm sóc chính ........................................................................................................109

Chuyên gia ..........................................................................................................................110

Chuyên gia ..........................................................................................................................119

Bác sĩ chăm sóc chính ........................................................................................................120

Chuyên gia ..........................................................................................................................120

Chuyên gia ..........................................................................................................................125

Bác sĩ chăm sóc chính ........................................................................................................127

Chuyên gia ..........................................................................................................................127

Bác sĩ chăm sóc chính ........................................................................................................134

Châm cứu............................................................................................................................136

Nhà cung cấp sức khỏe tâm thần .......................................................................................221

Nhà cung cấp tầm nhìn .......................................................................................................254

Cơ sở sức khỏe tâm thần ...................................................................................................319

Các hiệu thuốc bán lẻ và chuỗi ...........................................................................................320

Nhà thuốc chăm sóc dài hạn...............................................................................................326

Chỉ số nhà cung cấp ...........................................................................................................327

Chỉ số nhà thuốc .................................................................................................................333

Nếu quý vị có thắc mắc, vui lòng gọi Blue Shield Promise Cal MediConnect Plan theo số 1-855-905-3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. bảy ngày mỗi tuần. Cuộc gọi được miễn phí. Để tìm

hiểu thêm, truy cập www.blueshieldca.com/promise/calmediconnect.

III

Page 6: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS ALLIED PHYSICIANS IPA OF CA DBA ALLIED PACIFIC IPA

PRIMARY CARE PHYSICIANS

Family Practice

ALHAMBRA

91801

Aguilar, Felix MD

320 S Garfield Ave Ste 118

Alhambra, CA 91801

(213) 808-1792

Provider ID: 120629

License: A64940

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Burmese,

Cantonese, 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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

COVINA

91723

Gin, Jeffrey MD

218 W Badillo St

Covina, CA 91723

(310) 991-7718

Provider ID: 80685

License: A101609

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

LOS ANGELES

90001

Akhavan, Parviz DO

723 E Manchester Ave

Los Angeles, CA 90001

(323) 750-2325

Provider ID: 208229

License: 20A7522

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

90037

Akhavan, Parviz DO

5113 S Vermont Ave

Los Angeles, CA 90037

(323) 305-2220

Provider ID: 208230

License: 20A7522

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 1change

Page 7: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS ALLIED PHYSICIANS IPA OF CA DBA ALLIED PACIFIC IPA

Accepting New Members: Yes Other Language: Chinese, office to discuss their

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

WEST COVINA

91792

MONTEREY PARK

91754

Tai, Liang Yu DO

210 N Garfield Ave Ste 203

Monterey Park, CA 91754

(626) 307-7397

Provider ID: 217200

License: 20A7444

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Mandarin, Spanish,

Taiwanese, 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.

NORWALK

90650

Bejinez-eastman, Ana MD

13820 San Antonio Dr

Norwalk, CA 90650

(562) 944-2181

Provider ID: 209015

License: G67654

Credentials and/or board

certification: No

Accepting 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.

Chen, David MD

2707 E Valley Blvd Ste 203

West Covina, CA 91792

(626) 965-1988

Provider ID: 109805

License: A82411

Credentials and/or board

certification: No

Accepting New Members: No

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.

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 2change

Page 8: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS ALLIED PHYSICIANS IPA OF CA DBA ALLIED PACIFIC IPA

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) 338-4088

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.

Internal Medicine

MONTEREY PARK

91754

Ganata, Victor MD

210 N Garfield Ave Ste 203

Monterey Park, CA 91754

(626) 307-7397

Provider ID: 85833

License: A95477

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

ROWLAND HEIGHTS

91748

Yung, Tin MD

1722 Desire Ave Ste 202

Rowland Heights, CA 91748

(626) 913-1288

Provider ID: 85824

License: G61730

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Cantonese,

Chinese, Indonesian,

Japanese, 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.

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

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 3change

Page 9: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS ALLIED PHYSICIANS IPA OF CA DBA ALLIED PACIFIC IPA

must receive a referral from

your primary care physician.

Dermatology

SHERMAN OAKS

91403

Lin, Michael MD

15477 Ventura Blvd Ste 100

Sherman Oaks, CA 91403

(818) 906-6900

Provider ID: 23833

License: A77571

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Chinese,

Mandarin, Spanish, Tagalog,

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.

Endocrinology

WHITTIER

90605

Eitan, Nathan MD

9200 Colima Rd Ste 200

Whittier, CA 90605

(562) 945-2833

Provider ID: 22457

License: A36074

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Hebrew,

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.

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.

Surgery General

CITY OF INDUSTRY

91748

Tran, Young MD

18605 Gale Ave Ste 180

City Of Industry, CA 91748

(626) 457-6333

Provider ID: 252367

License: A66589

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Cantonese,

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.

Special Expertise: Deafness or

Hard-of-Hearing, Co-occuring

Disorders

UPDATE: NEW Provider Added.

Effective_Date: 11-FEB-20

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 4change

Page 10: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS ALLIED PHYSICIANS IPA OF CA DBA ALLIED PACIFIC IPA

Tran, Young MD

18605 Gale Ave Ste 180

City Of Industry, CA 91748

(626) 457-6333

Provider ID: 252367

License: A66589

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Cantonese,

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.

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.

Wu, Bob MD

18605 Gale Ave Ste 180

City Of Industry, CA 91748

(626) 457-6333

Provider ID: 252405

License: A101512

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Chinese,

Mandarin, Spanish,

Taiwanese, 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: Deafness or

Hard-of-Hearing, Co-occuring

Disorders

UPDATE: NEW Provider Added.

Effective_Date: 11-FEB-20

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 5change

Page 11: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS ALTAMED - MONTEREY PARK

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

LOS ANGELES

90024

Javdan, Parviz MD

1762 Westwood Blvd Ste 110

Los Angeles, CA 90024

(310) 441-2000

License: A34960

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Armenian,

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Hematology / Oncology

LAKEWOOD

90805

Cheung, Eric DO

3300 E South St Ste 304

Lakewood, CA 90805

(562) 262-0550

License: 20A9006

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Armenian,

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Ophthalmology

Optometrist

LOS ANGELES

90712

Khanna, Sandeep MD

5750 Downey Ave Ste 101

Lakewood, CA 90712

(562) 211-5462

License: A48969

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; 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 6change

Page 12: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS ALTAMED - MONTEREY PARK

90057

Perez, Evelyn OD

139 S Alvarado St

Los Angeles, CA 90057

(323) 728-5500

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.

MONTEBELLO

90640

Perez, Evelyn OD

2446 W Whittier Blvd

Montebello, CA 90640

(714) 558-1385

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.

Surgery General

MONTEREY PARK

91754

Kim, Sean MD

600 N Garfield Ave Ste 210

Monterey Park, CA 91754

(626) 281-9111

License: A123580

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Lee, Dustin DO

600 N Garfield Ave Ste 210

Monterey Park, CA 91754

(626) 281-9111

License: 20A10484

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

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 7change

Page 13: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS ALTAMED - MONTEREY PARK

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.

Surgery Neurological

LOS ANGELES

90033

Najafi, Ali MD

1700 E Cesar E Chavez Ave

Ste 2200

Los Angeles, CA 90033

(323) 264-7600

License: A74093

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: There was a change

in the provider record;

demographic, phone and/or

panel status.

Surgery Orthopedic

MONTEREY PARK

91754

Barba, David MD

880 S Atlantic Blvd Ste 205

Monterey Park, CA 91754

(626) 289-0178

License: A135899

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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.

Urology

LOS ANGELES

90057

Naraghi, Robert MD

2200 W 3rd St Ste 500

Los Angeles, CA 90057

(213) 484-5551

License: G83950

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Farsi,

Persian

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.

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 8change

Page 14: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS ALTAMED HEALTH SERVICES CORPORATION

PRIMARY CARE PHYSICIANS

Family Practice

BALDWIN PARK

91706

Urbina, Marvin MD

14342 Ramona Blvd

Baldwin Park, CA 91706

(626) 338-4088

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.

LOS ANGELES

90057

Gill, Matthew DO

2100 W 3rd St Ste 400

Los Angeles, CA 90057

(888) 499-9303

Provider ID: 252494

License: 20A17547

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; 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.

Gutierrez, Guillermina MD

2100 W 3rd St Ste 400

Los Angeles, CA 90057

(888) 499-9303

Provider ID: 253091

License: A76597

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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.

Yoo, Carlos MD

2100 W 3rd St Ste 400

Los Angeles, CA 90057

(888) 499-9303

Provider ID: 248301

License: A124289

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Korean,

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 9change

Page 15: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS ALTAMED HEALTH SERVICES CORPORATION

Accessibility: B; 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: 03-FEB-20

NORWALK

90650

Bejinez-eastman, Ana MD

13820 San Antonio Dr

Norwalk, CA 90650

(562) 944-2181

Provider ID: 240814

License: G67654

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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) 338-4088

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

panel status.

HUNTINGTON PARK

90255

Tran, Daniel MD

2765 E Florence Ave

Huntington Park, CA 90255

(323) 588-6888

Provider ID: 48858

License: G77436

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: 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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Internal Medicine

Bereliani, Arash MD

6120 Seville 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 10change

Page 16: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS ALTAMED HEALTH SERVICES CORPORATION

Huntington Park, CA 90255

(323) 588-8855

Provider ID: 252815

License: A66268

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.

UPDATE: NEW Provider Added.

Effective_Date: 20-FEB-20

LOS ANGELES

90026

Filart, Marcel Adrian MD

1711 W Temple St Ste 1070

Los Angeles, CA 90026

(323) 499-1350

Provider ID: 128894

License: A76022

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.

90057

Bereliani, Arash MD

1919 W 7th St Unit 2a

Los Angeles, CA 90057

(213) 413-2222

Provider ID: 245887

License: A66268

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.

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.

Family Practice Sports

Medicine

COVINA

91723

Khan, Ahmed MD

315 N 3rd Ave Ste 302

Covina, CA 91723

(626) 332-1194

Provider ID: 248351

License: A161223

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 11change

Page 17: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS ALTAMED HEALTH SERVICES CORPORATION

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Hematology / Oncology

LAKEWOOD

90805

Cheung, Eric DO

3300 E South St Ste 304

Lakewood, CA 90805

(562) 262-0550

Provider ID: 45406

License: 20A9006

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Armenian,

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Interventional Cardiology

LOS ANGELES

90027

Lee, Edwin MD

1300 N Vermont Ave Ste 808

Los Angeles, CA 90027

(323) 913-4303

Provider ID: 247726

License: A110733

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Chinese, Farsi, Korean,

Mandarin, 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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Nephrology

SAN DIMAS

91773

Bhasin, Nitin MD

1335 Cypress St Ste 205

San Dimas, CA 91773

(909) 542-2770

Provider ID: 87684

License: A109234

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

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 12change

Page 18: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS ALTAMED HEALTH SERVICES CORPORATION

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.

Obstetrics / Gynecology

LOS ANGELES

90027

Gumbs, Joslyn MD

1300 N Vermont Ave Ste 804

Los Angeles, CA 90027

(323) 257-1814

Provider ID: 252961

License: A87245

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: NEW Provider Added.

Effective_Date: 31-JAN-20

Ophthalmology

LAKEWOOD

90712

Khanna, Sandeep MD

5750 Downey Ave Ste 101

Lakewood, CA 90712

(562) 211-5462

Provider ID: 240494

License: A48969

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; 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.

LOS ANGELES

90015

Gallemore, Ron MD

1414 S Grand Ave Ste 105

Los Angeles, CA 90015

(213) 749-5555

Provider ID: 103188

License: G78240

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Armenian,

Cantonese, Italian,

Japanese, Korean,

Mandarin, 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.

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 13change

Page 19: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS ALTAMED HEALTH SERVICES CORPORATION

WHITTIER

90602

Shammas, Hanna MD

7957 Painter Ave Ste 101

Whittier, CA 90602

(562) 464-0590

Provider ID: 248044

License: A30800

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

French, Russian, 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.

Special Expertise: Deafness or

Hard-of-Hearing, Co-occuring

Disorders

UPDATE: NEW Provider Added.

Effective_Date: 28-JAN-20

Optometrist

HUNTINGTON PARK

90255

Mishima, Todd OD

2715 E Florence Ave

Huntington Park, CA 90255

(323) 581-0120

Provider ID: 20179

License: OPT9700

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

LOS ANGELES

90057

Perez, Evelyn OD

139 S Alvarado St

Los Angeles, CA 90057

(323) 728-5500

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

Cultural Competency: NR

Accessibility: B; 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.

MONTEBELLO

90640

Perez, Evelyn OD

2446 W Whittier Blvd

Montebello, CA 90640

(714) 558-1385

Provider ID: 244073

License: OPT10155

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 14change

Page 20: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS ALTAMED HEALTH SERVICES CORPORATION

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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.

Radiology Diagnostic X-ray

BELLFLOWER

90706

Hakham, Salar DO

16506 Lakewood Blvd Ste 200

Bellflower, CA 90706

Provider ID: 253252

License: 20A13968

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Surgery General

MONTEREY PARK

91754

Lee, Dustin DO

600 N Garfield Ave Ste 210

Monterey Park, CA 91754

(626) 281-9111

Provider ID: 245512

License: 20A10484

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

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.

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

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 15change

Page 21: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS ALTAMED HEALTH SERVICES CORPORATION

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Surgery Orthopedic

COVINA

91723

Patel, Ankur MD

315 N 3rd Ave Ste 302

Covina, CA 91723

(626) 332-1194

Provider ID: 248207

License: A130850

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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.

Yeranosian, Michael MD

315 N 3rd Ave Ste 302

Covina, CA 91723

(626) 332-1194

Provider ID: 248197

License: A153721

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

GLENDORA

91741

Wong, Kee MD

412 W Carroll Ave Ste 107

Glendora, CA 91741

(626) 914-4890

Provider ID: 248187

License: G32749

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Urology

LOS ANGELES

90017

Kowalczyk, John DO

1127 Wilshire Blvd Ste 805

Los Angeles, CA 90017

(213) 670-7675

Provider ID: 245435

License: 20A6818

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 16change

Page 22: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS ALTAMED HEALTH SERVICES CORPORATION

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Polish,

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.

Scott, Dana MD

1127 Wilshire Blvd Ste 805

Los Angeles, CA 90017

(213) 670-7675

Provider ID: 114030

License: A100321

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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

Naraghi, Robert MD

2200 W 3rd St Ste 500

Los Angeles, CA 90057

(213) 484-5551

Provider ID: 88275

License: G83950

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Farsi,

Persian

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.

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 17change

Page 23: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS ANGELES IPA

PRIMARY CARE PHYSICIANS

General Practice

HUNTINGTON PARK

90255

Galdamez, Luis MD

6831 Seville Ave

Huntington Park, CA 90255

(323) 581-8234

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.

LOS ANGELES

90044

Feygin, Polina MD

10024 S Vermont Ave

Los Angeles, CA 90044

(323) 756-1412

Provider ID: 115293

License: G67378

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.

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.

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.

Ophthalmology

CITY OF INDUSTRY

91748

Chang, Tom MD

17833 Colima Rd

City Of Industry, CA 91748

(323) 221-8000

Provider ID: 34662

License: A69909

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Armenian, Cantonese,

Chinese, Korean, Mandarin,

Serbo-Croatian, 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 18change

Page 24: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS ANGELES IPA

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

TORRANCE

90505

DOWNEY

90241

Davis, Michael MD

11525 Brookshire Ave # 201a

Downey, CA 90241

(800) 898-2020

Provider ID: 62265

License: A111866

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: 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.

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.

Suk, Kevin MD

11525 Brookshire Ave # 201a

Downey, CA 90241

(800) 898-2020

Provider ID: 70207

License: A114509

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Armenian,

Cantonese, Korean,

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.

Special Expertise: Deafness or

Hard-of-Hearing, Co-occuring

Disorders

Roe, Richard MD

3400 Lomita Blvd Ste 202

Torrance, CA 90505

(310) 591-1000

Provider ID: 52027

License: A95880

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Armenian,

Korean, Mandarin, 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.

Special Expertise: Deafness or

Hard-of-Hearing, Co-occuring

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 19change

Page 25: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS ANGELES IPA

Disorders panel status.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Surgery Orthopedic

LYNWOOD

90262

Goring, Christopher MD

3628 E Imperial Hwy Ste 300

Lynwood, CA 90262

(310) 900-4788

Provider ID: 214205

License: C55914

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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 20change

Page 26: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS APPLECARE MEDICAL GROUP- DOWNEY

PRIMARY CARE PHYSICIANS

Family Practice

NORWALK

Internal Medicine

CARSON

90650

Bejinez-eastman, Ana MD

13820 San Antonio Dr

Norwalk, CA 90650

(562) 944-2181

Provider ID: 129612

License: G67654

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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.

PICO RIVERA

90660

Pinkerton, Ronald MD

8337 Telegraph Rd Ste 102

Pico Rivera, CA 90660

(562) 445-3181

Provider ID: 210764

License: G64676

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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

DOWNEY

90240

Rubinson, William MD

8500 Florence Ave Ste 101

Downey, CA 90240

(562) 923-6060

Provider ID: 105020

License: A16990

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Gujarati, Hebrew, Hindi,

Marathi, Spanish

Cultural Competency: NR

Accessibility: B; 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.

90745

Aguinaldo, Estrella MD

23517 Main St Ste 104

Carson, CA 90745

(310) 233-2555

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 21change

Page 27: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS APPLECARE MEDICAL GROUP- DOWNEY

Provider ID: 33332

License: A56493

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Samoan,

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.

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.

Endocrinology

WHITTIER

90605

Eitan, Nathan MD

9200 Colima Rd Ste 200

Whittier, CA 90605

(562) 945-2833

Provider ID: 22457

License: A36074

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Hebrew,

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.

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.

Hematology / Oncology

LAKEWOOD

90805

Cheung, Eric DO

3300 E South St Ste 304

Lakewood, CA 90805

(562) 262-0550

Provider ID: 74393

License: 20A9006

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Armenian,

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.

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 22change

Page 28: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS APPLECARE MEDICAL GROUP- SELECT

PRIMARY CARE PHYSICIANS

Family Practice

NORWALK

90650

Bejinez-eastman, Ana MD

13820 San Antonio Dr

Norwalk, CA 90650

(562) 944-2181

Provider ID: 129608

License: G67654

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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.

PICO RIVERA

90660

Pinkerton, Ronald MD

8337 Telegraph Rd Ste 102

Pico Rivera, CA 90660

(562) 445-3181

Provider ID: 210766

License: G64676

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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

DOWNEY

90240

Rubinson, William MD

8500 Florence Ave Ste 101

Downey, CA 90240

(562) 923-6060

Provider ID: 105021

License: A16990

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Gujarati, Hebrew, Hindi,

Marathi, Spanish

Cultural Competency: NR

Accessibility: B; 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

CARSON

90745

Aguinaldo, Estrella MD

23517 Main St Ste 104

Carson, CA 90745

(310) 233-2555

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 23change

Page 29: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS APPLECARE MEDICAL GROUP- SELECT

Provider ID: 57270

License: A56493

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Samoan,

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.

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.

Hematology / Oncology

LAKEWOOD

90805

Cheung, Eric DO

3300 E South St Ste 304

Lakewood, CA 90805

(562) 262-0550

Provider ID: 74393

License: 20A9006

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Armenian,

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.

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 24change

Page 30: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS APPLECARE MEDICAL GROUP- WHITTIER

PRIMARY CARE PHYSICIANS

Family Practice

General Practice

DOWNEY

NORWALK

90650

Bejinez-eastman, Ana MD

13820 San Antonio Dr

Norwalk, CA 90650

(562) 944-2181

Provider ID: 129610

License: G67654

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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.

PICO RIVERA

90660

Pinkerton, Ronald MD

8337 Telegraph Rd Ste 102

Pico Rivera, CA 90660

(562) 445-3181

Provider ID: 210765

License: G64676

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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.

90240

Rubinson, William MD

8500 Florence Ave Ste 101

Downey, CA 90240

(562) 923-6060

Provider ID: 108737

License: A16990

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Gujarati, Hebrew, Hindi,

Marathi, Spanish

Cultural Competency: NR

Accessibility: B; 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.

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 25change

Page 31: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS APPLECARE MEDICAL GROUP- WHITTIER

Endocrinology

WHITTIER

90605

Eitan, Nathan MD

9200 Colima Rd Ste 200

Whittier, CA 90605

(562) 945-2833

Provider ID: 22457

License: A36074

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Hebrew,

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.

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.

Hematology / Oncology

LAKEWOOD

90805

Cheung, Eric DO

3300 E South St Ste 304

Lakewood, CA 90805

(562) 262-0550

Provider ID: 74393

License: 20A9006

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Armenian,

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.

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 26change

Page 32: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS APPLECARE MEDICAL GROUP-ST FRANCIS

PRIMARY CARE PHYSICIANS

General Practice

DOWNEY

90240

Rubinson, William MD

8500 Florence Ave Ste 101

Downey, CA 90240

(562) 923-6060

Provider ID: 105019

License: A16990

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Gujarati, Hebrew, Hindi,

Marathi, Spanish

Cultural Competency: NR

Accessibility: B; 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

CARSON

90745

Aguinaldo, Estrella MD

23517 Main St Ste 104

Carson, CA 90745

(310) 233-2555

Provider ID: 28861

License: A56493

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Samoan,

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.

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 27change

Page 33: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS COMMUNITY FAMILY CARE - VALLEY PRES

PRIMARY CARE PHYSICIANS

General Practice

HUNTINGTON PARK

90255

Tran, Daniel MD

2765 E Florence Ave

Huntington Park, CA 90255

(323) 588-6888

Provider ID: 33782

License: G77436

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; 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.

must receive a referral from

your primary care physician.

Gastroenterology

90045

Ojuri, Adebambo MD

8110 Airport Blvd Fl 2

Los Angeles, CA 90045

(310) 674-0144

Provider ID: 74620

License: A46336

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Cantonese,

Farsi, 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.

Otolaryngology

LOS ANGELES

90004

Carella, Joseph MD

326 N Vermont Ave

Los Angeles, CA 90004

(213) 383-9955

Provider ID: 68359

License: G15628

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 28change

Page 34: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS COMMUNITY FAMILY CARE - VALLEY PRES

VAN NUYS

91405

Eubanks, Hayward MD

15216 Vanowen St Ste 2c

Van Nuys, CA 91405

(310) 679-0676

Provider ID: 22367

License: G54388

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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.

Eghbalieh, Sammy MD

19950 Rinaldi St # 101d

Porter Ranch, CA 91326

(818) 900-6480

Provider ID: 116476

License: A133688

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Surgery General Vascular

PORTER RANCH

91326

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 29change

Page 35: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS FAMILY CARE SPECIALIST IPA

UPDATE: There was a change (818) 240-9041SPECIALISTS

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

GLENDALE

91203

Aleman, Edgar MD

500 N Central Ave Ste 800

Glendale, CA 91203

(818) 240-9041

License: G53591

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.

in the provider record;

demographic, phone and/or

panel status.

Khachatryan, Tigran MD

500 N Central Ave Ste 800

Glendale, CA 91203

(818) 240-9041

License: A127412

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Riffel-dalinger, Hugo MD

500 N Central Ave Ste 800

Glendale, CA 91203

License: A30878

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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.

Sadrzadeh Rafie, Amir MD

500 N Central Ave Ste 800

Glendale, CA 91203

(818) 240-9041

License: A115445

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Fataleka, Persian

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 30change

Page 36: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS FAMILY CARE SPECIALIST IPA

Cultural Competency: NR

Accessibility: B; 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

LAKEWOOD

90805

Cheung, Eric DO

3300 E South St Ste 304

Lakewood, CA 90805

(562) 262-0550

License: 20A9006

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Armenian,

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Ophthalmology

PASADENA

91105

Su, Daniel MD

301 S Fair Oaks Ave Ste 407

Pasadena, CA 91105

(626) 204-1410

License: A134110

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Chinese,

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Podiatrist

LOS ANGELES

90033

Nalamlieng, Matthew DPM

1720 E Cesar E Chavez Ave

Los Angeles, CA 90033

(323) 268-5000

License: DPM5316

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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: 29-JAN-20

Nalamlieng, Matthew DPM

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 31change

Page 37: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS FAMILY CARE SPECIALIST IPA

1828 E Cesar E Chavez Ave

Ste 4600

Los Angeles, CA 90033

(323) 307-8585

License: DPM5316

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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: 29-JAN-20

Surgery Orthopedic

MONTEREY PARK

91754

Barba, David MD

880 S Atlantic Blvd Ste 205

Monterey Park, CA 91754

(626) 289-0178

License: A135899

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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 32change

Page 38: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTH CARE LA IPA

PRIMARY CARE PHYSICIANS

Internal Medicine

LOS ANGELES

90002

Ahmed, Rabia MD

10300 Compton Ave

Los Angeles, CA 90002

(323) 564-4331

Provider ID: 81017

License: A44227

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Aparicio, Luis MD

10300 Compton Ave

Los Angeles, CA 90002

(323) 564-4331

Provider ID: 26253

License: A45564

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

90013

Lee, Edward MD

311 Winston St

Los Angeles, CA 90013

(213) 893-1960

Provider ID: 252381

License: A131695

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.

UPDATE: NEW Provider Added.

Effective_Date: 11-FEB-20

90026

Al-sarraf, Lena DO

180 Union Pl

Los Angeles, CA 90026

(323) 644-3885

Provider ID: 70769

License: 20A6339

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, W; 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 33change

Page 39: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTH CARE LA IPA

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.

Cardiology

POMONA

91767

Discepolo, William MD

1866 N Orange Grove Ave Ste

202

Pomona, CA 91767

(909) 622-3065

Provider ID: 87054

License: A85753

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.

Parikh, Gaurav MD

1866 N Orange Grove Ave Ste

202

Pomona, CA 91767

(909) 398-1550

Provider ID: 108720

License: A142679

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.

Cardiovascular Disease

TORRANCE

90505

Bharadia, Juma MD

22617 Hawthorne Blvd

Torrance, CA 90505

(310) 370-4700

Provider ID: 87343

License: A56515

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Gujarati,

Hindi, Kannada, Sindhi,

Spanish, Swahili, 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.

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 34change

Page 40: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTH CARE LA IPA

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Certified Nurse Practitioner

CANYON COUNTRY

91351

Turner, Beckie NP

27225 Camp Plenty Rd Ste 4

Canyon Country, CA 91351

(661) 424-1220

Provider ID: 248231

License: NP95002248

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; 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: 31-JAN-20

HUNTINGTON PARK

90255

Marrin, Bridget NP

7301 State St

Huntington Park, CA 90255

(323) 581-5120

Provider ID: 248858

License: NP20063

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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

90037

Poon, Lalita NP

4085 S Vermont Ave

Los Angeles, CA 90037

(323) 541-1600

Provider ID: 248302

License: NP95008213

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; 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.

90047

Poon, Lalita NP

1555 W 110th St

Los Angeles, CA 90047

(323) 541-1411

Provider ID: 248303

License: NP95008213

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 35change

Page 41: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTH CARE LA IPA

Accessibility: B; 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.

NORWALK

90650

Bertao, Teresa NP

12360 Firestone Blvd

Norwalk, CA 90650

(562) 867-7999

Provider ID: 252583

License: NP10178

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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

91767

Lucasan, Danah Majorie NP

255 E Bonita Ave # 1a

Pomona, CA 91767

(909) 450-0377

Provider ID: 252647

License: NP95011876

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

WEST COVINA

91790

Bernal, Brenda NP

420 S Glendora Ave

West Covina, CA 91790

(626) 919-5724

Provider ID: 252952

License: NP6269180175

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; 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.

Dermatology

LONG BEACH

90803

Lazzaro, Cynthia 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 36change

Page 42: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTH CARE LA IPA

5865 E Naples Plz

Long Beach, CA 90803

(310) 541-7800

Provider ID: 252382

License: 20A12781

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Chinese,

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

ROLLING HILLS ESTATES

90274

Lazzaro, Cynthia DO

550 Deep Valley Dr Ste 283

Rolling Hills Estates, CA 90274

(310) 541-7800

Provider ID: 252384

License: 20A12781

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Chinese,

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.

UPDATE: NEW Provider Added.

Effective_Date: 11-FEB-20

SHERMAN OAKS

91403

Lin, Michael MD

15477 Ventura Blvd Ste 100

Sherman Oaks, CA 91403

(818) 906-6900

Provider ID: 241643

License: A77571

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Chinese,

Mandarin, Spanish, Tagalog,

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.

TORRANCE

90505

Lazzaro, Cynthia DO

23451 Madison St Ste 190

Torrance, CA 90505

(310) 373-6952

Provider ID: 252385

License: 20A12781

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Chinese,

Mandarin

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 37change

Page 43: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTH CARE LA 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: NEW Provider Added.

Effective_Date: 11-FEB-20

Gastroenterology

GARDENA

90247

Shah, Anoop MD

1141 W Redondo Beach Blvd

Ste 212

Gardena, CA 90247

(562) 299-0224

Provider ID: 252655

License: A91301

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Gujarati,

Hindi, 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.

UPDATE: NEW Provider Added.

Effective_Date: 18-FEB-20

LANCASTER

93534

Pruthi, Jatinder MD

44215 15th St W Ste 209

Lancaster, CA 93534

(661) 522-4507

Provider ID: 245571

License: A64919

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.

LONG BEACH

90806

Saliminejad, Mehrdad MD

2801 Atlantic Ave

Long Beach, CA 90806

(562) 933-0971

Provider ID: 248098

License: A106054

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: 29-JAN-20

POMONA

91767

Tama, Maher MD

790 E Bonita Ave # 2

Pomona, CA 91767

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 38change

Page 44: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTH CARE LA IPA

(909) 447-5893

Provider ID: 252970

License: A161762

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

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

LAKEWOOD

90805

Cheung, Eric DO

3300 E South St Ste 304

Lakewood, CA 90805

(562) 262-0550

Provider ID: 74393

License: 20A9006

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Armenian,

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Hospice and Palliative

Medicine

LOS ANGELES

90024

Roozrokh, Babak MD

1700 Westwood Blvd

Los Angeles, CA 90024

(800) 941-4161

Provider ID: 74671

License: A81646

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Nephrology

GLENDALE

91203

Arcia, John MD

435 Arden Ave Ste 380

Glendale, CA 91203

(818) 244-9575

Provider ID: 17167

License: G70558

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 39change

Page 45: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPSHEALTH CARE LA IPA

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.

Neurology

POMONA

91767

Popalzai, Adeel DO

2895 N Towne Ave

Pomona, CA 91767

(909) 982-2719

Provider ID: 129533

License: 20A10930

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Obstetrics / Gynecology

LONG BEACH

90806

Masaki, Damon MD

2801 Atlantic Ave

Long Beach, CA 90806

(562) 837-4500

Provider ID: 213977

License: G45365

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; 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

90026

Pine, Stephen MD

150 N Reno St

Los Angeles, CA 90026

(323) 635-1140

Provider ID: 248338

License: C33483

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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-FEB-20

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

Call Member Services if you need information about a provider’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 46: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTH CARE LA IPA

90037

Battala, Naga MD

5701 S Hoover St

Los Angeles, CA 90037

(323) 541-1411

Provider ID: 252344

License: A104785

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.

MONTEBELLO

90640

Hanna, Gina MD

101 E Beverly Blvd Ste 104

Montebello, CA 90640

(626) 337-4425

Provider ID: 248384

License: G87504

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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.

VAN NUYS

91405

Delshad, George MD

15211 Vanowen St Ste 310

Van Nuys, CA 91405

(818) 830-6970

Provider ID: 252830

License: G83566

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Oncology Medical

SAN PEDRO

90732

Nobile, Lucio MD

1360 W 6th St Ste G

San Pedro, CA 90732

(310) 547-2445

Provider ID: 252837

License: A81546

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 41change

Page 47: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTH CARE LA IPA

Other Language: French,

German, Italian, 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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

TORRANCE

90503

Nobile, Lucio MD

4305 Torrance Blvd Ste 109

Torrance, CA 90503

(310) 935-4525

Provider ID: 252840

License: A81546

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: French,

German, Italian, 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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Ophthalmology

CITY OF INDUSTRY

91748

Chang, Tom MD

17833 Colima Rd

City Of Industry, CA 91748

(323) 221-8000

Provider ID: 34662

License: A69909

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Armenian, Cantonese,

Chinese, Korean, Mandarin,

Serbo-Croatian, Spanish

Cultural Competency: NR

Accessibility: B; 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.

Chen, Brian MD

17833 Colima Rd

City Of Industry, CA 91748

(323) 221-8000

Provider ID: 104901

License: A127719

Credentials and/or board

certification: Yes

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Armenian,

Cantonese, Chinese,

Mandarin, 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 42change

Page 48: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTH CARE LA IPA

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.

DOWNEY

90241

Davis, Michael MD

11525 Brookshire Ave # 201a

Downey, CA 90241

(800) 898-2020

Provider ID: 62265

License: A111866

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: 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.

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.

Suk, Kevin MD

11525 Brookshire Ave # 201a

Downey, CA 90241

(800) 898-2020

Provider ID: 70207

License: A114509

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Armenian,

Cantonese, Korean,

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.

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.

GLENDALE

91202

Mahdavi, Paymohn MD

1025 N Brand Blvd Ste 200

Glendale, CA 91202

(818) 583-9933

Provider ID: 252743

License: A162708

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: There was a change

in the provider record;

demographic, phone and/or

panel status.

GLENDORA

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 43change

Page 49: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTH CARE LA IPA

91741

Mahdavi, Paymohn MD

150 S Grand Ave Ste 1

Glendora, CA 91741

(626) 335-2114

Provider ID: 252744

License: A162708

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: There was a change

in the provider record;

demographic, phone and/or

panel status.

LAKEWOOD

90712

Khanna, Sandeep MD

5750 Downey Ave Ste 101

Lakewood, CA 90712

(562) 211-5462

Provider ID: 118004

License: A48969

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.

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

90808

Renner, Morgan MD

3816 Woodruff Ave Ste 100

Long Beach, CA 90808

(562) 424-0931

Provider ID: 128383

License: A142841

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; 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

90015

Gallemore, Ron MD

1414 S Grand Ave Ste 105

Los Angeles, CA 90015

(213) 749-5555

Provider ID: 103188

License: G78240

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Armenian,

Cantonese, Italian,

Japanese, Korean,

Mandarin, Russian, 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 44change

Page 50: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTH CARE LA IPA

Cultural Competency: NR

Accessibility: B; 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.

90017

Steinschriber, Steven MD

1127 Wilshire Blvd Ste 504

Los Angeles, CA 90017

(800) 898-2020

Provider ID: 126635

License: G56229

Credentials and/or board

certification: Yes

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.

90031

Chen, Brian MD

2400 N Broadway

Los Angeles, CA 90031

(323) 221-6121

Provider ID: 87355

License: A127719

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Armenian,

Cantonese, 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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

PASADENA

91105

Bedrood, Sahar MD

100 E California Blvd

Pasadena, CA 91105

(800) 898-2020

Provider ID: 126430

License: A124192

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; 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.

Su, Daniel 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 45change

Page 51: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTH CARE LA IPA

301 S Fair Oaks Ave Ste 407

Pasadena, CA 91105

(626) 204-1410

Provider ID: 249021

License: A134110

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Chinese,

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

91107

Mahdavi, Paymohn MD

2619 E Colorado Blvd Ste 150

Pasadena, CA 91107

(626) 793-4168

Provider ID: 252741

License: A162708

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: There was a change

in the provider record;

demographic, phone and/or

panel status.

POMONA

91767

Davis, Michael MD

160 E Artesia St Ste 120

Pomona, CA 91767

(800) 898-2020

Provider ID: 46846

License: A111866

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: 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.

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.

91768

Khan, Ayaz DO

648 N Park Ave

Pomona, CA 91768

(909) 566-2393

Provider ID: 127713

License: 20A9417

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: 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 46change

Page 52: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTH CARE LA 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.

TORRANCE

90505

Chu, Thomas MD

3400 Lomita Blvd Ste 202

Torrance, CA 90505

(310) 591-1000

Provider ID: 9136

License: G68694

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Armenian,

Korean, Mandarin, 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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Optometrist

LOS ANGELES

90015

Yang, Nicole OD

1530 S Olive St

Los Angeles, CA 90015

(213) 747-5542

Provider ID: 248456

License: OPT13990

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Chinese,

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.

UPDATE: NEW Provider Added.

Effective_Date: 05-FEB-20

SAN PEDRO

90732

Wong, Sharon OD

1360 W 6th St Ste 165

San Pedro, CA 90732

(800) 898-2020

Provider ID: 245276

License: OPT15137

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; 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.

TORRANCE

90505

Wong, Sharon OD

3440 Lomita Blvd Ste 100

Torrance, CA 90505

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 47change

Page 53: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTH CARE LA IPA

(800) 898-2020

Provider ID: 245277

License: OPT15137

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; 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.

Physical Medicine /

Rehabilitation

VAN NUYS

91405

Niamehr, Nouriel DO

14600 Sherman Way Ste 250

Van Nuys, CA 91405

(818) 506-5197

Provider ID: 123527

License: 20A11311

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Podiatrist

GARDENA

90247

Yu, Kelly DPM

1045 W Redondo Beach Blvd

Ste 106

Gardena, CA 90247

(310) 323-2887

Provider ID: 70297

License: DPM4999

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Cantonese,

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.

HAWTHORNE

90250

Benson, Erica DPM

13624 Hawthorne Blvd Ste 206

Hawthorne, CA 90250

(310) 675-0900

Provider ID: 252585

License: DPM5462

Credentials and/or board

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 48change

Page 54: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTH CARE LA IPA

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.

Radiology

BEVERLY HILLS

90211

Mahgerefteh, Shmuel MD

145 S Doheny Dr

Beverly Hills, CA 90211

(310) 550-5858

Provider ID: 252327

License: A142017

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: There was a change

in the provider record;

demographic, phone and/or

panel status.

LONG BEACH

90808

Mahgerefteh, Shmuel MD

3320 N Los Coyotes Diagonal

Ste 112

Long Beach, CA 90808

(562) 627-0903

Provider ID: 252333

License: A142017

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: There was a change

in the provider record;

demographic, phone and/or

panel status.

LOS ANGELES

90006

Mahgerefteh, Shmuel MD

2560 W Olympic Blvd Ste 100

Los Angeles, CA 90006

(323) 703-1000

Provider ID: 252332

License: A142017

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: There was a change

in the provider record;

demographic, phone and/or

panel status.

90020

Eckel, Gregory MD

500 S Virgil Ave Ste 102

Los Angeles, CA 90020

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 49change

Page 55: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTH CARE LA IPA

(323) 375-3950

Provider ID: 207778

License: A72806

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

NORTH HOLLYWOOD

91602

Mahgerefteh, Shmuel MD

10767 Riverside Dr

North Hollywood, CA 91602

(818) 301-6700

Provider ID: 252326

License: A142017

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: There was a change

in the provider record;

demographic, phone and/or

panel status.

POMONA

91767

Ho, Ralph MD

2475 N Garey Ave

Pomona, CA 91767

(909) 622-3166

Provider ID: 252429

License: C53547

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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.

TARZANA

91356

Mahgerefteh, Shmuel MD

18388 Clark St Ste 115

Tarzana, CA 91356

(818) 609-0911

Provider ID: 252330

License: A142017

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: 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 50change

Page 56: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTH CARE LA IPA

demographic, phone and/or

panel status.

Mahgerefteh, Shmuel MD

5620 Wilbur Ave Ste 330

Tarzana, CA 91356

(818) 345-3285

Provider ID: 252331

License: A142017

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: There was a change

in the provider record;

demographic, phone and/or

panel status.

VAN NUYS

91405

Eckel, Gregory MD

15107 Vanowen St

Van Nuys, CA 91405

(818) 200-4330

Provider ID: 207767

License: A72806

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; 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.

91411

Mahgerefteh, Shmuel MD

14915 Burbank Blvd

Van Nuys, CA 91411

(818) 909-7111

Provider ID: 252329

License: A142017

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: There was a change

in the provider record;

demographic, phone and/or

panel status.

WEST HILLS

91307

Mahgerefteh, Shmuel MD

7345 Medical Center Dr Ste

130

West Hills, CA 91307

(818) 710-6011

Provider ID: 252328

License: A142017

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

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 51change

Page 57: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTH CARE LA IPA

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 Vascular

MARINA DEL REY

90292

Vlada, Claudiu MD

4560 Admiralty Way Ste 356

Marina Del Rey, CA 90292

(310) 306-2744

Provider ID: 240099

License: A154999

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Korean,

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

accessibility indicators are not

present.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

PORTER RANCH

91326

Eghbalieh, Sammy MD

19950 Rinaldi St # 101d

Porter Ranch, CA 91326

(818) 900-6480

Provider ID: 116476

License: A133688

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Surgery General

COMPTON

90222

Philip, Ancil MD

2251 W Rosecrans Ave Ste 21

Compton, CA 90222

(424) 529-6755

Provider ID: 119601

License: C147208

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

EL SEGUNDO

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 52change

Page 58: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTH CARE LA IPA

License: A107927 PTA: No

LONG BEACH

90806

90245

Aliksanian, Lori MD

222 N Sepulveda Blvd Ste 2175

El Segundo, CA 90245

(310) 524-1300

Provider ID: 101449

License: A122286

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Green, Sari MD

222 N Sepulveda Blvd Ste 2175

El Segundo, CA 90245

(310) 524-1300

Provider ID: 101496

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Brady, Matthew MD

2801 Atlantic Ave

Long Beach, CA 90806

(562) 933-1877

Provider ID: 212142

License: A148963

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Surgery Neurological

LOS ANGELES

90033

Najafi, Ali MD

1700 E Cesar E Chavez Ave

Ste 2200

Los Angeles, CA 90033

(323) 264-7600

Provider ID: 252772

License: A74093

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

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 53change

Page 59: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTH CARE LA 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.

Surgery Orthopedic

90015

Eromo, Ersno MD

1513 S Grand Ave Ste 300

Los Angeles, CA 90015

(424) 262-7306

Provider ID: 240609

License: C145666

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Amharic,

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

present.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

90057

Goring, Christopher MD

2200 W 3rd St Ste 400

Los Angeles, CA 90057

(213) 484-7600

Provider ID: 214206

License: C55914

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.

HOLLYWOOD

90028

Marmureanu, Alexandru MD

6253 Hollywood Blvd Apt 1108

Hollywood, CA 90028

(310) 208-4400

Provider ID: 122417

License: A72254

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: French,

Greek, Italian, 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

accessibility indicators are not

present.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

accessibility indicators are not Surgery Thoracic

Urology

LOS ANGELES

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 54change

Page 60: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTH CARE LA IPA

90017

Kowalczyk, John DO

1127 Wilshire Blvd Ste 805

Los Angeles, CA 90017

(213) 670-7675

Provider ID: 104634

License: 20A6818

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Polish,

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.

Scott, Dana MD

1127 Wilshire Blvd Ste 805

Los Angeles, CA 90017

(213) 670-7675

Provider ID: 114030

License: A100321

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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.

REDONDO BEACH

90277

Ahmed, Faisal MD

510 N Prospect Ave Ste 115

Redondo Beach, CA 90277

(424) 390-4291

Provider ID: 242536

License: A123658

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.

Malhotra, Sameer MD

510 N Prospect Ave Ste 115

Redondo Beach, CA 90277

(424) 390-4291

Provider ID: 241293

License: A76279

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: French,

Hindi, Punjabi, 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 55change

Page 61: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTH CARE LA 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.

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 56change

Page 62: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTHCARE PARTNERS

PRIMARY CARE PHYSICIANS SPECIALISTS

Family Practice

DOWNEY

90240

Rubinson, William MD

8500 Florence Ave Ste 101

Downey, CA 90240

(562) 923-6060

Provider ID: 214234

License: A16990

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Gujarati, Hebrew, Hindi,

Marathi, Spanish

Cultural Competency: NR

Accessibility: B; 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.

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.

Cardiovascular Disease

POMONA

91767

Discepolo, William MD

1866 N Orange Grove Ave Ste

202

Pomona, CA 91767

(909) 622-3065

Provider ID: 87054

License: A85753

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.

Gastroenterology

LOS ANGELES

90045

Ojuri, Adebambo MD

8110 Airport Blvd Fl 2

Los Angeles, CA 90045

(310) 674-0144

Provider ID: 12706

License: A46336

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Cantonese,

Farsi, 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;

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 57change

Page 63: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTHCARE PARTNERS

Infectious Disease 91203demographic, phone and/or

panel status.

Hospice and Palliative

Medicine

ARCADIA

91006

Lee, Jae MD

450 E Huntington Dr

Arcadia, CA 91006

(626) 462-1884

Provider ID: 75017

License: A109172

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

present.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Santos-montemayor, Maria

MD

450 E Huntington Dr

Arcadia, CA 91006

(626) 254-2172

Provider ID: 91250

License: A79424

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Nephrology

GLENDALE

Arcia, John MD

435 Arden Ave Ste 380

Glendale, CA 91203

(818) 244-9575

Provider ID: 17167

License: G70558

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; 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

ARCADIA

91006

Slater, Kurt 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 58change

Page 64: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTHCARE PARTNERS

450 E Huntington Dr

Arcadia, CA 91006

(626) 462-1884

Provider ID: 34477

License: 20A5469

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Optometrist

LONG BEACH

90808

Grattan, Anne OD

5991 E Spring St

Long Beach, CA 90808

(562) 938-9945

Provider ID: 124948

License: OPT15086

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Podiatrist

ARCADIA

91006

Martin, Anthony DPM

450 E Huntington Dr

Arcadia, CA 91006

(626) 254-2172

Provider ID: 34609

License: DPM3619

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Rheumatology

Soleimani, Massoud MD

450 E Huntington Dr

Arcadia, CA 91006

(626) 254-2172

Provider ID: 34589

License: A67910

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; 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 59change

Page 65: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTHCARE PARTNERS

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

EL SEGUNDO

90245

Cruz-schiavone, Gonzalo MD

222 N Sepulveda Blvd Ste 2175

El Segundo, CA 90245

(310) 524-1300

Provider ID: 123910

License: A134319

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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 Thoracic

LOS ANGELES

90033

Barr, Mark MD

1520 San Pablo St Ste 4300

Los Angeles, CA 90033

(323) 442-5849

Provider ID: 90995

License: G75945

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.

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 60change

Page 66: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTHCARE PARTNERS IPA - EAST WEST

PRIMARY CARE PHYSICIANS

Family Practice

WEST COVINA

91792

Chen, David MD

2707 E Valley Blvd Ste 203

West Covina, CA 91792

(626) 965-1988

Provider ID: 99087

License: A82411

Credentials and/or board

certification: No

Accepting New Members: No

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.

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 61change

Page 67: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTHCARE PARTNERS IPA - GLENDALE

PRIMARY CARE PHYSICIANS

Family Practice

GLENDALE

91205

Airapetian, Ara MD

801 S Chevy Chase Dr Ste 250

Glendale, CA 91205

(818) 265-2259

Provider ID: 252345

License: A86421

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Armenian,

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

LOS ANGELES

90057

Burns, John MD

2252 Beverly Blvd Ste 101

Los Angeles, CA 90057

(213) 252-7281

Provider ID: 238785

License: A41985

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Armenian,

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.

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.

Cardiovascular Disease

90033

Mckenzie, John MD

1701 E Cesar E Chavez Ave

Ste 355

Los Angeles, CA 90033

(323) 225-8025

Provider ID: 244214

License: G71752

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Armenian, Farsi, French,

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 62change

Page 68: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTHCARE PARTNERS IPA - GLENDALE

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 63change

Page 69: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTHCARE PARTNERS IPA - LAC

PRIMARY CARE PHYSICIANS

Internal Medicine

LOS ANGELES

90026

Filart, Marcel Adrian MD

1711 W Temple St Ste 1070

Los Angeles, CA 90026

(323) 499-1350

Provider ID: 212050

License: A76022

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.

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 64change

Page 70: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTHCARE PARTNERS IPA - LCM

PRIMARY CARE PHYSICIANS

Internal Medicine

CARSON

Family Practice

SAN PEDRO

90731

Shah, Krupa MD

1294 W 6th St Ste 204

San Pedro, CA 90731

(310) 832-5331

Provider ID: 71609

License: A42668

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

General Practice

TORRANCE

90505

Ramos, Enrique MD

22525 Maple Ave Ste 100

Torrance, CA 90505

(310) 538-9400

Provider ID: 248309

License: G30295

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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: 03-FEB-20

90745

Aguinaldo, Estrella MD

23517 Main St Ste 104

Carson, CA 90745

(310) 233-2555

Provider ID: 68080

License: A56493

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Samoan,

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

SAN PEDRO

90731

Genato, Sharon MD

1600 S Gaffey St

San Pedro, CA 90731

(310) 548-0201

Provider ID: 252503

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 65change

Page 71: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTHCARE PARTNERS IPA - LCM

License: A51792

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.

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.

90746

Marsh, Adrienne NP

1000 E Dominguez St Ste 110

Carson, CA 90746

(310) 715-7755

Provider ID: 248355

License: NP95010379

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; 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.

(310) 373-0250

Provider ID: 248140

License: A149592

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: 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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Endocrinology

TORRANCE

90505

Pham, Cindy MD

3640 Lomita Blvd Ste 305

Torrance, CA 90505

Certified Nurse Practitioner

CARSON

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 66change

Page 72: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTHCARE PARTNERS IPA - LONG BEACH

PRIMARY CARE PHYSICIANS

Family Practice

DOWNEY

90240

Rubinson, William MD

8500 Florence Ave Ste 101

Downey, CA 90240

(562) 923-6060

Provider ID: 238497

License: A16990

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Gujarati, Hebrew, Hindi,

Marathi, Spanish

Cultural Competency: NR

Accessibility: B; 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

LONG BEACH

90813

Ellis, Arnold MD

934 Atlantic Ave

Long Beach, CA 90813

(323) 732-0100

Provider ID: 240509

License: A31480

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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.

Infectious Disease

Hean, Sindalisa MD

1043 Elm Ave Ste 301

Long Beach, CA 90813

(562) 624-4943

Provider ID: 250549

License: A137717

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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 Cardiovascular

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 67change

Page 73: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTHCARE PARTNERS IPA - LONG BEACH

90806

Mahtabifard, Ali MD

2810 Long Beach Blvd Fl 3

Long Beach, CA 90806

(562) 933-1877

Provider ID: 248078

License: A86440

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi, 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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Mahtabifard, Ali MD

2801 Atlantic Ave

Long Beach, CA 90806

(562) 933-0971

Provider ID: 248080

License: A86440

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi, 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.

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 68change

Page 74: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTHCARE PARTNERS IPA - NORTHRIDGE MEDICAL GROUP

PRIMARY CARE PHYSICIANS

Family Practice

NORTHRIDGE

91325

Eddy-bertrand, Elizabeth MD

18350 Roscoe Blvd Ste 600

Northridge, CA 91325

(818) 727-1515

Provider ID: 49320

License: G80676

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: 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.

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.

Podiatrist

91324

Binder, Robert DPM

9017 Reseda Blvd Ste 100

Northridge, CA 91324

(818) 885-8400

Provider ID: 252288

License: DPM2485

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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 69change

Page 75: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTHCARE PARTNERS IPA - SFV

PRIMARY CARE PHYSICIANS

Family Practice

NORTHRIDGE

91325

Eddy-bertrand, Elizabeth MD

18350 Roscoe Blvd Ste 600

Northridge, CA 91325

(818) 727-1515

Provider ID: 29688

License: G80676

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: 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.

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 70change

Page 76: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTHCARE PARTNERS IPA - SO BAY

PRIMARY CARE PHYSICIANS

Family Practice

SAN PEDRO

90731

Shah, Krupa MD

1294 W 6th St Ste 204

San Pedro, CA 90731

(310) 832-5331

Provider ID: 71608

License: A42668

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

TORRANCE

90505

Yu, Michael MD

3333 Skypark Dr Ste 100

Torrance, CA 90505

(310) 784-6300

Provider ID: 73124

License: A80648

Credentials and/or board

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

General Practice

Ramos, Enrique MD

22525 Maple Ave Ste 100

Torrance, CA 90505

(310) 538-9400

Provider ID: 248310

License: G30295

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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: 03-FEB-20

Internal Medicine

CARSON

90745

Aguinaldo, Estrella MD

23517 Main St Ste 104

Carson, CA 90745

(310) 233-2555

Provider ID: 68079

License: A56493

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 71change

Page 77: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTHCARE PARTNERS IPA - SO BAY

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Samoan,

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

SAN PEDRO

90731

Genato, Sharon MD

1600 S Gaffey St

San Pedro, CA 90731

(310) 548-0201

Provider ID: 252502

License: A51792

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.

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.

Certified Nurse Practitioner

CARSON

90746

Marsh, Adrienne NP

1000 E Dominguez St Ste 110

Carson, CA 90746

(310) 715-7755

Provider ID: 248354

License: NP95010379

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; 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.

Endocrinology

TORRANCE

90505

Pham, Cindy MD

3640 Lomita Blvd Ste 305

Torrance, CA 90505

(310) 373-0250

Provider ID: 248139

License: A149592

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Thai

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 72change

Page 78: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTHCARE PARTNERS IPA - SO BAY

Accessibility: B; 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 73change

Page 79: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTHCARE PARTNERS IPA-TALBERT OC

PRIMARY CARE PHYSICIANS

Family Practice

DOWNEY

90240

Rubinson, William MD

8500 Florence Ave Ste 101

Downey, CA 90240

(562) 923-6060

Provider ID: 214941

License: A16990

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Gujarati, Hebrew, Hindi,

Marathi, Spanish

Cultural Competency: NR

Accessibility: B; 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.

LONG BEACH

90813

Ellis, Arnold MD

934 Atlantic Ave

Long Beach, CA 90813

(323) 732-0100

Provider ID: 241087

License: A31480

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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.

Pulmonary Diseases

90806

Jiang, Thomas MD

2865 Atlantic Ave Ste 205

Long Beach, CA 90806

(562) 988-9333

Provider ID: 252555

License: A119331

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.

UPDATE: NEW Provider Added.

Effective_Date: 14-FEB-20

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 74change

Page 80: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTHCARE PARTNERS MEDICAL GROUP - ARCADIA

PRIMARY CARE PHYSICIANS

Internal Medicine

ARCADIA

91006

Ho, Samuel MD

450 E Huntington Dr

Arcadia, CA 91006

(626) 462-1884

Provider ID: 39359

License: A93329

Credentials and/or board

certification: Yes

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Santos-montemayor, Maria

MD

450 E Huntington Dr

Arcadia, CA 91006

(626) 254-2172

Provider ID: 30395

License: A79424

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.

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.

Surgery General

91007

Hwee, Jonathan MD

612 W Duarte Rd Ste 804

Arcadia, CA 91007

(626) 600-2094

Provider ID: 252488

License: A160641

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; 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 75change

Page 81: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTHCARE PARTNERS MEDICAL GROUP - ATLANTIC

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.

Infectious Disease

LONG BEACH

90813

Hean, Sindalisa MD

1043 Elm Ave Ste 301

Long Beach, CA 90813

(562) 624-4943

License: A137717

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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 Cardiovascular

90806

Mahtabifard, Ali MD

2810 Long Beach Blvd Fl 3

Long Beach, CA 90806

(562) 933-1877

License: A86440

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi, 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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Mahtabifard, Ali MD

2801 Atlantic Ave

Long Beach, CA 90806

(562) 933-0971

License: A86440

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi, 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.

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 76change

Page 82: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTHCARE PARTNERS MEDICAL GROUP - BURBANK

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.

Endocrinology

BURBANK

91506

Sharifi, Maryam MD

2211 W Magnolia Blvd Ste 120

Burbank, CA 91506

(818) 955-5773

License: A126378

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: There was a change

in the provider record;

demographic, phone and/or

panel status.

NORTHRIDGE

91324

Sharifi, Maryam MD

18546 Roscoe Blvd Ste 300

Northridge, CA 91324

(818) 886-4028

License: A126378

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: There was a change

in the provider record;

demographic, phone and/or

panel status.

VAN NUYS

91405

Sharifi, Maryam MD

14600 Sherman Way Ste 300

Van Nuys, CA 91405

(818) 781-7097

License: A126378

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: There was a change

in the provider record;

demographic, phone and/or

panel status.

Podiatrist

NORTHRIDGE

91324

Binder, Robert DPM

9017 Reseda Blvd Ste 100

Northridge, CA 91324

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 77change

Page 83: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTHCARE PARTNERS MEDICAL GROUP - BURBANK

(818) 885-8400

License: DPM2485

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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 78change

Page 84: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTHCARE PARTNERS MEDICAL GROUP - GLENDALE

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.

accessibility indicators are not

present.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Cardiovascular Disease

LOS ANGELES

90033

Mckenzie, John MD

1701 E Cesar E Chavez Ave

Ste 355

Los Angeles, CA 90033

(323) 225-8025

License: G71752

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Armenian, Farsi, French,

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

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 79change

Page 85: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTHCARE PARTNERS MEDICAL GROUP - VAN NUYS

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.

in the provider record;

demographic, phone and/or

panel status.

Podiatrist

NORTHRIDGE

91324

Binder, Robert DPM

9017 Reseda Blvd Ste 100

Northridge, CA 91324

(818) 885-8400

License: DPM2485

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 80change

Page 86: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTHCARE PARTNERS MEDICAL GROUP- BIXBY KNOLLS LONG BEACH

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.

Infectious Disease

LONG BEACH

90813

Hean, Sindalisa MD

1043 Elm Ave Ste 301

Long Beach, CA 90813

(562) 624-4943

License: A137717

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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 Cardiovascular

90806

Mahtabifard, Ali MD

2810 Long Beach Blvd Fl 3

Long Beach, CA 90806

(562) 933-1877

License: A86440

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi, 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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Mahtabifard, Ali MD

2801 Atlantic Ave

Long Beach, CA 90806

(562) 933-0971

License: A86440

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi, 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.

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 81change

Page 87: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS HEALTHCARE PARTNERS MEDICAL GROUP-MAGNOLIA

in the provider record;SPECIALISTS

demographic, phone and/or Members may not self-refer to panel status. any of the specialists listed

below. To receive covered

services from a specialist you

must receive a referral from

your primary care physician.

Podiatrist

NORTHRIDGE

91324

Binder, Robert DPM

9017 Reseda Blvd Ste 100

Northridge, CA 91324

(818) 885-8400

License: DPM2485

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 82change

Page 88: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS KOREAN AMERICAN MEDICAL GROUP

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.

Optometrist

HUNTINGTON PARK

90255

Mishima, Todd OD

2715 E Florence Ave

Huntington Park, CA 90255

(323) 581-0120

License: OPT9700

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Urology

LOS ANGELES

90017

Kowalczyk, John DO

1127 Wilshire Blvd Ste 805

Los Angeles, CA 90017

(213) 670-7675

License: 20A6818

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Polish,

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.

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 83change

Page 89: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS LOS ANGELES MEDICAL CENTER IPA

PRIMARY CARE PHYSICIANS

Family Practice

LONG BEACH

90813

Ellis, Arnold MD

934 Atlantic Ave

Long Beach, CA 90813

(323) 732-0100

Provider ID: 242457

License: A31480

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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

90001

Akhavan, Parviz DO

723 E Manchester Ave

Los Angeles, CA 90001

(323) 750-2325

Provider ID: 102049

License: 20A7522

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

90037

Akhavan, Parviz DO

5113 S Vermont Ave

Los Angeles, CA 90037

(323) 305-2220

Provider ID: 102055

License: 20A7522

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

General Practice

HUNTINGTON PARK

90255

Galdamez, Luis MD

6831 Seville Ave

Huntington Park, CA 90255

(323) 581-8234

Provider ID: 98164

License: A48644

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 84change

Page 90: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS LOS ANGELES MEDICAL CENTER IPA

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.

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 85change

Page 91: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS PHYSICIANS ASSOC SAN GABRIEL VALLEY

PRIMARY CARE PHYSICIANS

Family Practice

BALDWIN PARK

91706

Urbina, Marvin MD

14342 Ramona Blvd

Baldwin Park, CA 91706

(626) 338-4088

Provider ID: 36766

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.

COVINA

91723

Gin, Jeffrey MD

218 W Badillo St

Covina, CA 91723

(310) 991-7718

Provider ID: 63467

License: A101609

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

MONTEREY PARK

91754

Tai, Liang Yu DO

210 N Garfield Ave Ste 203

Monterey Park, CA 91754

(626) 307-7397

Provider ID: 73194

License: 20A7444

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Chinese,

Mandarin, Spanish,

Taiwanese, 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.

Internal Medicine

ROWLAND HEIGHTS

91748

Yung, Tin MD

1722 Desire Ave Ste 202

Rowland Heights, CA 91748

(626) 913-1288

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 86change

Page 92: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS PHYSICIANS ASSOC SAN GABRIEL VALLEY

Provider ID: 53318

License: G61730

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Cantonese,

Chinese, Indonesian,

Japanese, 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.

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.

Surgery General

ARCADIA

91007

Hwee, Jonathan MD

612 W Duarte Rd Ste 804

Arcadia, CA 91007

(626) 600-2094

Provider ID: 252489

License: A160641

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; 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 87change

Page 93: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS PREFERRED IPA OF CALIFORNIA

PRIMARY CARE PHYSICIANS

Family Practice

ARLETA

91331

Arceo, Ruth MD

9043 Woodman Ave Ste C

Arleta, CA 91331

(818) 221-3096

Provider ID: 125541

License: A53097

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

NORWALK

90650

Bejinez-eastman, Ana MD

13820 San Antonio Dr

Norwalk, CA 90650

(562) 944-2181

Provider ID: 124006

License: G67654

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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

HUNTINGTON PARK

90255

Tran, Daniel MD

2765 E Florence Ave

Huntington Park, CA 90255

(323) 588-6888

Provider ID: 114738

License: G77436

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; 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

90044

Feygin, Polina MD

10024 S Vermont Ave

Los Angeles, CA 90044

(323) 756-1412

Provider ID: 202067

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 88change

Page 94: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS PREFERRED IPA OF CALIFORNIA

License: G67378

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.

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

COMPTON

90220

Saied, Saied MD

349 W Compton Blvd

Compton, CA 90220

(424) 785-5170

Provider ID: 113390

License: A54467

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Amharic,

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.

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.

Cardiovascular Disease

LOS ANGELES

90033

Mckenzie, John MD

1701 E Cesar E Chavez Ave

Ste 355

Los Angeles, CA 90033

(323) 225-8025

Provider ID: 86910

License: G71752

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Armenian, Farsi, French,

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.

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 89change

Page 95: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS PREFERRED IPA OF CALIFORNIA

90505

Tabandeh, Homayoun MD

3400 Lomita Blvd Ste 202

Torrance, CA 90505

(310) 591-1000

Provider ID: 115225

License: A89087

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Armenian,

Chinese, Farsi, Korean,

Mandarin, 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.

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.

LOS ANGELES

90015

Houser, Natalie PA

1414 S Grand Ave Ste 200

Los Angeles, CA 90015

(213) 419-9600

Provider ID: 248461

License: PA51701

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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: 05-FEB-20

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 90change

Page 96: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS PRIMARY CARE ASSOCIATES OF CALIFORNIA

HUNTINGTON PARK

90255

CARSON

90745

PRIMARY CARE PHYSICIANS

Family Practice

NORWALK

90650

Bejinez-eastman, Ana MD

13820 San Antonio Dr

Norwalk, CA 90650

(562) 944-2181

Provider ID: 200700

License: G67654

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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.

Galdamez, Luis MD

6831 Seville Ave

Huntington Park, CA 90255

(323) 581-8234

Provider ID: 85004

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.

Aguinaldo, Estrella MD

23517 Main St Ste 104

Carson, CA 90745

(310) 233-2555

Provider ID: 81216

License: A56493

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Samoan,

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.

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 General Practice

Internal Medicine

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 91change

Page 97: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS PRIMARY CARE ASSOCIATES OF CALIFORNIA

services from a specialist you

must receive a referral from

your primary care physician.

Cardiology

DOWNEY

LOS ANGELES

90045

90241

Floro, Jerry MD

11480 Brookshire Ave Ste 300

Downey, CA 90241

(562) 977-1690

Provider ID: 73935

License: G42959

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

INGLEWOOD

90301

Bridges, Duane MD

575 E Hardy St Ste 306

Inglewood, CA 90301

(424) 227-6619

Provider ID: 81689

License: G63954

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Dermatology

SHERMAN OAKS

91403

Lin, Michael MD

15477 Ventura Blvd Ste 100

Sherman Oaks, CA 91403

(818) 906-6900

Provider ID: 23833

License: A77571

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Chinese,

Mandarin, Spanish, Tagalog,

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.

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 92change

Page 98: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS PRIMARY CARE ASSOCIATES OF CALIFORNIA

Ojuri, Adebambo MD

8110 Airport Blvd Fl 2

Los Angeles, CA 90045

(310) 674-0144

Provider ID: 81464

License: A46336

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Cantonese,

Farsi, 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.

License: 20A6818

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Polish,

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.

Urology

90017

Kowalczyk, John DO

1127 Wilshire Blvd Ste 805

Los Angeles, CA 90017

(213) 670-7675

Provider ID: 9706

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 93change

Page 99: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS PROSPECT HEALTHSOURCE MEDICAL GROUP

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.

Dermatology

SHERMAN OAKS

91403

Lin, Michael MD

15477 Ventura Blvd Ste 100

Sherman Oaks, CA 91403

(818) 906-6900

License: A77571

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Chinese,

Mandarin, Spanish, Tagalog,

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.

Gastroenterology

LOS ANGELES

90045

Ojuri, Adebambo MD

8110 Airport Blvd Fl 2

Los Angeles, CA 90045

(310) 674-0144

License: A46336

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Cantonese,

Farsi, 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.

Ophthalmology

TORRANCE

90505

Chu, Thomas MD

3400 Lomita Blvd Ste 202

Torrance, CA 90505

(310) 591-1000

License: G68694

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Armenian,

Korean, Mandarin, 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.

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 94change

Page 100: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS PROSPECT HEALTHSOURCE MEDICAL GROUP

Tabandeh, Homayoun MD

3400 Lomita Blvd Ste 202

Torrance, CA 90505

(310) 591-1000

License: A89087

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Armenian,

Chinese, Farsi, Korean,

Mandarin, 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.

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.

Optometrist

SAN PEDRO

90732

Wong, Sharon OD

1360 W 6th St Ste 165

San Pedro, CA 90732

(800) 898-2020

License: OPT15137

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; 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.

TORRANCE

90505

Wong, Sharon OD

3440 Lomita Blvd Ste 100

Torrance, CA 90505

(800) 898-2020

License: OPT15137

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; 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.

Radiation Oncology

MONTEBELLO

90640

Thropay, John MD

120 W Beverly Blvd

Montebello, CA 90640

(323) 724-8780

License: G32178

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 95change

Page 101: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS PROSPECT HEALTHSOURCE MEDICAL GROUP

Other Language: Cambodian,

Gujarati, Hindi, Korean,

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Rheumatology

CULVER CITY

90232

Gilbert, Randall MD

9808 Venice Blvd Ste 603

Culver City, CA 90232

(310) 842-7500

License: G55905

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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 Neurological

MONTEREY PARK

91754

Chou, Arthur MD

605 N Garfield Ave Ste 1f

Monterey Park, CA 91754

(626) 768-7373

License: A111306

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Chinese,

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Surgery Thoracic

HOLLYWOOD

90028

Marmureanu, Alexandru MD

6253 Hollywood Blvd Apt 1108

Hollywood, CA 90028

(310) 208-4400

License: A72254

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: French,

Greek, Italian, 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

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 96change

Page 102: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS PROSPECT HEALTHSOURCE MEDICAL GROUP

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Urology

LOS ANGELES

90017

Kowalczyk, John DO

1127 Wilshire Blvd Ste 805

Los Angeles, CA 90017

(213) 670-7675

License: 20A6818

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Polish,

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.

Scott, Dana MD

1127 Wilshire Blvd Ste 805

Los Angeles, CA 90017

(213) 670-7675

License: A100321

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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 97change

Page 103: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS PROSPECT MEDICAL GROUP-LOS ANGELES

PRIMARY CARE PHYSICIANS

General Practice

MONTEBELLO

90640

Gonzalez, Enrique MD

120 S Montebello Blvd

Montebello, CA 90640

(310) 991-7718

Provider ID: 119223

License: G74790

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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.

Cardiology

LOS ANGELES

90033

Bansal, Eric MD

1701 E Cesar E Chavez Ave

Ste 125

Los Angeles, CA 90033

(323) 441-1122

Provider ID: 253249

License: A122292

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; 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: 28-FEB-20

Hematology / Oncology

LAKEWOOD

90805

Cheung, Eric DO

3300 E South St Ste 304

Lakewood, CA 90805

(562) 262-0550

Provider ID: 74393

License: 20A9006

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Armenian,

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Ophthalmology

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 98change

Page 104: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS PROSPECT MEDICAL GROUP-LOS ANGELES

DOWNEY

90241

Davis, Michael MD

11525 Brookshire Ave # 201a

Downey, CA 90241

(800) 898-2020

Provider ID: 62265

License: A111866

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: 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.

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.

Suk, Kevin MD

11525 Brookshire Ave # 201a

Downey, CA 90241

(800) 898-2020

Provider ID: 202183

License: A114509

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Armenian,

Cantonese, Korean,

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.

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.

LAKEWOOD

90712

Khanna, Sandeep MD

5750 Downey Ave Ste 101

Lakewood, CA 90712

(562) 211-5462

Provider ID: 246806

License: A48969

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; 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.

PASADENA

91105

Bedrood, Sahar MD

100 E California Blvd

Pasadena, CA 91105

(800) 898-2020

Provider ID: 126430

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 99change

Page 105: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS PROSPECT MEDICAL GROUP-LOS ANGELES

License: A124192

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; 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

91767

Davis, Michael MD

160 E Artesia St Ste 120

Pomona, CA 91767

(800) 898-2020

Provider ID: 46846

License: A111866

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: 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.

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.

TORRANCE

90505

Chu, Thomas MD

3400 Lomita Blvd Ste 202

Torrance, CA 90505

(310) 591-1000

Provider ID: 9136

License: G68694

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Armenian,

Korean, Mandarin, 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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Optometrist

LAKEWOOD

90712

Duong, Henry OD

5750 Downey Ave Ste 101

Lakewood, CA 90712

(844) 211-5462

Provider ID: 248036

License: OPT15047

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 100change

Page 106: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS PROSPECT MEDICAL GROUP-LOS ANGELES

Accessibility: B; 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: 28-JAN-20

MONTEBELLO

90640

Duong, Henry OD

1717 W Beverly Blvd Ste A

Montebello, CA 90640

(844) 211-5462

Provider ID: 248035

License: OPT15047

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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

Kennedy, Devon OD

100 E California Blvd

Pasadena, CA 91105

(800) 898-2020

Provider ID: 252514

License: OPT34233

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; 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.

MONTEBELLO

90640

Thropay, John MD

120 W Beverly Blvd

Montebello, CA 90640

(323) 724-8780

Provider ID: 209093

License: G32178

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Cambodian,

Gujarati, Hindi, Korean,

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Radiation Oncology Surgery General

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 101change

Page 107: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS PROSPECT MEDICAL GROUP-LOS ANGELES

POMONA

91768

Wali, Autar MD

155 W Willow St

Pomona, CA 91768

(909) 868-2626

Provider ID: 247274

License: A32290

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Urology

LOS ANGELES

90017

Kowalczyk, John DO

1127 Wilshire Blvd Ste 805

Los Angeles, CA 90017

(213) 670-7675

Provider ID: 9706

License: 20A6818

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Polish,

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.

Scott, Dana MD

1127 Wilshire Blvd Ste 805

Los Angeles, CA 90017

(213) 670-7675

Provider ID: 114030

License: A100321

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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 102change

Page 108: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS PROSPECT MEDICAL GROUP-VAN NUYS

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.

Dermatology

SHERMAN OAKS

91403

Lin, Michael MD

15477 Ventura Blvd Ste 100

Sherman Oaks, CA 91403

(818) 906-6900

License: A77571

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Chinese,

Mandarin, Spanish, Tagalog,

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.

Nephrology

GLENDALE

91203

Arcia, John MD

435 Arden Ave Ste 380

Glendale, CA 91203

(818) 244-9575

License: G70558

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; 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

TARZANA

91356

Ahoubim, Daniel MD

18370 Burbank Blvd Ste 414

Tarzana, CA 91356

(818) 877-7715

License: A144380

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Hebrew

Cultural Competency: NR

Accessibility: B; 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.

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 103change

Page 109: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS PROSPECT MEDICAL GROUP-VAN NUYS

VAN NUYS

91405

Delshad, George MD

15211 Vanowen St Ste 310

Van Nuys, CA 91405

(818) 830-6970

License: G83566

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Ophthalmology

TORRANCE

Urology

LOS ANGELES

90505

Liao, David MD

3400 Lomita Blvd Ste 202

Torrance, CA 90505

(310) 591-1000

License: A112736

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Armenian,

Cantonese, Korean,

Mandarin, 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.

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.

Surgery General Vascular

PORTER RANCH

91326

Eghbalieh, Sammy MD

19950 Rinaldi St # 101d

Porter Ranch, CA 91326

(818) 900-6480

License: A133688

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

90017

Kowalczyk, John DO

1127 Wilshire Blvd Ste 805

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 104change

Page 110: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS PROSPECT MEDICAL GROUP-VAN NUYS

Los Angeles, CA 90017

(213) 670-7675

License: 20A6818

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Polish,

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.

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 105change

Page 111: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS PROSPECT NWOC MEDICAL GROUP-LA

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.

Hematology / Oncology

LAKEWOOD

90805

Cheung, Eric DO

3300 E South St Ste 304

Lakewood, CA 90805

(562) 262-0550

License: 20A9006

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Armenian,

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Ophthalmology

CITY OF INDUSTRY

91748

Chang, Tom MD

17833 Colima Rd

City Of Industry, CA 91748

(323) 221-8000

License: A69909

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Armenian, Cantonese,

Chinese, Korean, Mandarin,

Serbo-Croatian, Spanish

Cultural Competency: NR

Accessibility: B; 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.

DOWNEY

90241

Davis, Michael MD

11525 Brookshire Ave # 201a

Downey, CA 90241

(800) 898-2020

License: A111866

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: 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.

Special Expertise: Deafness or

Hard-of-Hearing, Co-occuring

Disorders

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 106change

Page 112: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS PROSPECT NWOC MEDICAL GROUP-LA

demographic, phone and/or

panel status.

Suk, Kevin MD

11525 Brookshire Ave # 201a

Downey, CA 90241

(800) 898-2020

License: A114509

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Armenian,

Cantonese, Korean,

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.

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.

PASADENA

91105

Bedrood, Sahar MD

100 E California Blvd

Pasadena, CA 91105

(800) 898-2020

License: A124192

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; 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

91767

Davis, Michael MD

160 E Artesia St Ste 120

Pomona, CA 91767

(800) 898-2020

License: A111866

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: 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.

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.

Radiation Oncology

MONTEBELLO

90640

Thropay, John MD

120 W Beverly Blvd

Montebello, CA 90640

(323) 724-8780

License: G32178

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 107change

Page 113: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS PROSPECT NWOC MEDICAL GROUP-LA

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Cambodian,

Gujarati, Hindi, Korean,

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.

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 108change

Page 114: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS PROSPECT PROFESSIONAL CARE MED GRP LA

PRIMARY CARE PHYSICIANS

Family Practice

NORWALK

90650

Bejinez-eastman, Ana MD

13820 San Antonio Dr

Norwalk, CA 90650

(562) 944-2181

Provider ID: 129300

License: G67654

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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

DOWNEY

90240

Rubinson, William MD

8500 Florence Ave Ste 101

Downey, CA 90240

(562) 923-6060

Provider ID: 107467

License: A16990

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Gujarati, Hebrew, Hindi,

Marathi, Spanish

Cultural Competency: NR

Accessibility: B; 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.

MONTEBELLO

90640

Gonzalez, Enrique MD

120 S Montebello Blvd

Montebello, CA 90640

(310) 991-7718

Provider ID: 119226

License: G74790

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: B; 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.

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 109change

Page 115: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS PROSPECT PROFESSIONAL CARE MED GRP LA

Cardiology

LOS ANGELES

90033

Bansal, Eric MD

1701 E Cesar E Chavez Ave

Ste 125

Los Angeles, CA 90033

(323) 441-1122

Provider ID: 253247

License: A122292

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; 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: 28-FEB-20

Dermatology

SHERMAN OAKS

91403

Lin, Michael MD

15477 Ventura Blvd Ste 100

Sherman Oaks, CA 91403

(818) 906-6900

Provider ID: 23833

License: A77571

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Chinese,

Mandarin, Spanish, Tagalog,

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.

Endocrinology

WHITTIER

90605

Eitan, Nathan MD

9200 Colima Rd Ste 200

Whittier, CA 90605

(562) 945-2833

Provider ID: 22457

License: A36074

Credentials and/or board

certification: Yes

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Hebrew,

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.

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.

Gastroenterology

LOS ANGELES

90045

Ojuri, Adebambo MD

8110 Airport Blvd Fl 2

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 110change

Page 116: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS PROSPECT PROFESSIONAL CARE MED GRP LA

Los Angeles, CA 90045

(310) 674-0144

Provider ID: 15391

License: A46336

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Cantonese,

Farsi, 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.

Hematology / Oncology

LAKEWOOD

90805

Cheung, Eric DO

3300 E South St Ste 304

Lakewood, CA 90805

(562) 262-0550

Provider ID: 45405

License: 20A9006

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Armenian,

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Neurology

MISSION HILLS

91345

Ahoubim, Daniel MD

11550 Indian Hills Rd Ste 200

Mission Hills, CA 91345

(818) 877-7758

Provider ID: 253009

License: A144380

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Hebrew

Cultural Competency: NR

Accessibility: B; 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: 25-FEB-20

TARZANA

91356

Ahoubim, Daniel MD

18370 Burbank Blvd Ste 414

Tarzana, CA 91356

(818) 877-7715

Provider ID: 242049

License: A144380

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Hebrew

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 111change

Page 117: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS PROSPECT PROFESSIONAL CARE MED GRP LA

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.

Obstetrics / Gynecology

VAN NUYS

91405

Delshad, George MD

15211 Vanowen St Ste 310

Van Nuys, CA 91405

(818) 830-6970

Provider ID: 252901

License: G83566

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Ophthalmology

CITY OF INDUSTRY

91748

Chang, Tom MD

17833 Colima Rd

City Of Industry, CA 91748

(323) 221-8000

Provider ID: 244379

License: A69909

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Armenian, Cantonese,

Chinese, Korean, Mandarin,

Serbo-Croatian, Spanish

Cultural Competency: NR

Accessibility: B; 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.

DOWNEY

90241

Davis, Michael MD

11525 Brookshire Ave # 201a

Downey, CA 90241

(800) 898-2020

Provider ID: 62265

License: A111866

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: 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.

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 112change

Page 118: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS PROSPECT PROFESSIONAL CARE MED GRP LA

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.

Suk, Kevin MD

11525 Brookshire Ave # 201a

Downey, CA 90241

(800) 898-2020

Provider ID: 202181

License: A114509

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Armenian,

Cantonese, Korean,

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.

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.

PASADENA

91105

Bedrood, Sahar MD

100 E California Blvd

Pasadena, CA 91105

(800) 898-2020

Provider ID: 126430

License: A124192

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; 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

91767

Davis, Michael MD

160 E Artesia St Ste 120

Pomona, CA 91767

(800) 898-2020

Provider ID: 46846

License: A111866

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: 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.

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.

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 113change

Page 119: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS PROSPECT PROFESSIONAL CARE MED GRP LA

90505

Chu, Thomas MD

3400 Lomita Blvd Ste 202

Torrance, CA 90505

(310) 591-1000

Provider ID: 9136

License: G68694

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Armenian,

Korean, Mandarin, 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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Liao, David MD

3400 Lomita Blvd Ste 202

Torrance, CA 90505

(310) 591-1000

Provider ID: 48973

License: A112736

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Armenian,

Cantonese, Korean,

Mandarin, 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.

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.

Tabandeh, Homayoun MD

3400 Lomita Blvd Ste 202

Torrance, CA 90505

(310) 591-1000

Provider ID: 115225

License: A89087

Credentials and/or board

certification: No

Accepting New Members: No

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Armenian,

Chinese, Farsi, Korean,

Mandarin, 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.

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.

Optometrist

PASADENA

91105

Kennedy, Devon OD

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 114change

Page 120: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS PROSPECT PROFESSIONAL CARE MED GRP LA

Provider ID: 252515 Cultural Competency: NR present.

License: OPT34233

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; 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.

SAN PEDRO

90732

Wong, Sharon OD

1360 W 6th St Ste 165

San Pedro, CA 90732

(800) 898-2020

Provider ID: 244000

License: OPT15137

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Accessibility: B; 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.

TORRANCE

90505

Wong, Sharon OD

3440 Lomita Blvd Ste 100

Torrance, CA 90505

(800) 898-2020

Provider ID: 244003

License: OPT15137

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; Members

should call the provider’s

office to discuss their

accessibility needs when there

is limited access or when

accessibility indicators are not

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Podiatrist

LOS ANGELES

90004

Lim, Thomas DPM

3367 W 1st St Ste 201

Los Angeles, CA 90004

(213) 483-4246

Provider ID: 248437

License: DPM4612

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;

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 115change

Page 121: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS PROSPECT PROFESSIONAL CARE MED GRP LA

demographic, phone and/or

panel status.

SHERMAN OAKS

91403

Lim, Thomas DPM

4955 Van Nuys Blvd Ste 107

Sherman Oaks, CA 91403

(800) 989-0225

Provider ID: 248436

License: DPM4612

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Korean,

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.

MONTEBELLO

90640

Thropay, John MD

120 W Beverly Blvd

Montebello, CA 90640

(323) 724-8780

Provider ID: 209091

License: G32178

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Cambodian,

Gujarati, Hindi, Korean,

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Radiation Oncology

Surgery General Vascular

PORTER RANCH

91326

Eghbalieh, Sammy MD

19950 Rinaldi St # 101d

Porter Ranch, CA 91326

(818) 900-6480

Provider ID: 116476

License: A133688

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Surgery General

POMONA

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 116change

Page 122: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS PROSPECT PROFESSIONAL CARE MED GRP LA

91768

Wali, Autar MD

155 W Willow St

Pomona, CA 91768

(909) 868-2626

Provider ID: 247273

License: A32290

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Surgery Neurological

MONTEREY PARK

91754

Chou, Arthur MD

605 N Garfield Ave Ste 1f

Monterey Park, CA 91754

(626) 768-7373

Provider ID: 248076

License: A111306

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Chinese,

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Surgery Thoracic

HOLLYWOOD

90028

Marmureanu, Alexandru MD

6253 Hollywood Blvd Apt 1108

Hollywood, CA 90028

(310) 208-4400

Provider ID: 203277

License: A72254

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: French,

Greek, Italian, 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

accessibility indicators are not

present.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Urology

LOS ANGELES

90017

Kowalczyk, John DO

1127 Wilshire Blvd Ste 805

Los Angeles, CA 90017

(213) 670-7675

Provider ID: 9706

License: 20A6818

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 117change

Page 123: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS PROSPECT PROFESSIONAL CARE MED GRP LA

Accepting New Members: Yes Cultural Competency: NR

Hours: M-SA 9AM-5PM Accessibility: B; Members

PTA: No should call the provider’s

Other Language: Polish, office to discuss their

Russian, Spanish accessibility needs when there

Cultural Competency: NR is limited access or when

Accessibility: B; Members accessibility indicators are not

should call the provider’s present.

office to discuss their UPDATE: There was a change

accessibility needs when there in the provider record;

is limited access or when demographic, phone and/or

accessibility indicators are not panel status.

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.

Scott, Dana MD

1127 Wilshire Blvd Ste 805

Los Angeles, CA 90017

(213) 670-7675

Provider ID: 114030

License: A100321

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 118change

Page 124: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS PROSPECT-DAEHAN

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.

accessibility indicators are not

present.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Radiation Oncology

MONTEBELLO

90640

Thropay, John MD

120 W Beverly Blvd

Montebello, CA 90640

(323) 724-8780

License: G32178

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Cambodian,

Gujarati, Hindi, Korean,

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

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 119change

Page 125: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS PROSPECT-NUESTRA FAMILIA MEDICAL GROUP

PRIMARY CARE PHYSICIANS

Family Practice

DOWNEY

90240

Rubinson, William MD

8500 Florence Ave Ste 101

Downey, CA 90240

(562) 923-6060

Provider ID: 245399

License: A16990

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

Gujarati, Hebrew, Hindi,

Marathi, Spanish

Cultural Competency: NR

Accessibility: B; 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

90023

Shah, Kiritkumar MD

3444 Whittier Blvd

Los Angeles, CA 90023

(323) 268-6751

Provider ID: 240444

License: A36850

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.

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.

Infectious Disease

LA PUENTE

91744

Chauhan, Bharat MD

18335 E Valley Blvd

La Puente, CA 91744

(626) 810-3330

Provider ID: 117306

License: A64947

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.

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 120change

Page 126: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS PROSPECT-NUESTRA FAMILIA MEDICAL GROUP

Ophthalmology

CITY OF INDUSTRY

91748

Chang, Tom MD

17833 Colima Rd

City Of Industry, CA 91748

(323) 221-8000

Provider ID: 244382

License: A69909

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Arabic,

Armenian, Cantonese,

Chinese, Korean, Mandarin,

Serbo-Croatian, Spanish

Cultural Competency: NR

Accessibility: B; 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.

DOWNEY

90241

Davis, Michael MD

11525 Brookshire Ave # 201a

Downey, CA 90241

(800) 898-2020

Provider ID: 62265

License: A111866

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: 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.

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.

Suk, Kevin MD

11525 Brookshire Ave # 201a

Downey, CA 90241

(800) 898-2020

Provider ID: 202185

License: A114509

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Armenian,

Cantonese, Korean,

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.

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

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 121change

Page 127: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS PROSPECT-NUESTRA FAMILIA MEDICAL GROUP

90808

Renner, Morgan MD

3816 Woodruff Ave Ste 100

Long Beach, CA 90808

(562) 424-0931

Provider ID: 205456

License: A142841

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; 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

Alasil, Tarek MD

2400 N Broadway

Los Angeles, CA 90031

(323) 221-6121

Provider ID: 207068

License: A108797

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Suk, Kevin MD

2400 N Broadway

Los Angeles, CA 90031

(800) 898-2020

Provider ID: 205419

License: A114509

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Armenian,

Cantonese, Korean,

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.

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.

PASADENA

91105

Bedrood, Sahar MD

100 E California Blvd

Pasadena, CA 91105

(800) 898-2020

Provider ID: 126430

License: A124192

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 122change

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LOS ANGELES COUNTY MEDICAL GROUPS PROSPECT-NUESTRA FAMILIA MEDICAL GROUP

Cultural Competency: NR

Accessibility: B; 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

91767

Davis, Michael MD

160 E Artesia St Ste 120

Pomona, CA 91767

(800) 898-2020

Provider ID: 46846

License: A111866

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: 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.

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.

TORRANCE

90505

Liao, David MD

3400 Lomita Blvd Ste 202

Torrance, CA 90505

(310) 591-1000

Provider ID: 48973

License: A112736

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Armenian,

Cantonese, Korean,

Mandarin, 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.

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.

Radiation Oncology

MONTEBELLO

90640

Thropay, John MD

120 W Beverly Blvd

Montebello, CA 90640

(323) 724-8780

Provider ID: 209095

License: G32178

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Cambodian,

Gujarati, Hindi, Korean,

Mandarin, Spanish, Tagalog,

Vietnamese

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 123change

Page 129: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS PROSPECT-NUESTRA FAMILIA MEDICAL GROUP

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 124change

Page 130: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS PROSPECT-SAN MIGUEL IPA

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

LOS ANGELES

90033

Bansal, Eric MD

1701 E Cesar E Chavez Ave

Ste 125

Los Angeles, CA 90033

(323) 441-1122

License: A122292

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; 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: 28-FEB-20

Ophthalmology

TORRANCE

90505

Chu, Thomas MD

3400 Lomita Blvd Ste 202

Torrance, CA 90505

(310) 591-1000

License: G68694

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Armenian,

Korean, Mandarin, 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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Liao, David MD

3400 Lomita Blvd Ste 202

Torrance, CA 90505

(310) 591-1000

License: A112736

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Armenian,

Cantonese, Korean,

Mandarin, 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.

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.

Novack, Roger MD

3400 Lomita Blvd Ste 202

Torrance, CA 90505

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 125change

Page 131: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS PROSPECT-SAN MIGUEL IPA

(310) 591-1000

License: G53779

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.

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.

Surgery Neurological

LOS ANGELES

90033

Najafi, Ali MD

1700 E Cesar E Chavez Ave

Ste 2200

Los Angeles, CA 90033

(323) 264-7600

License: A74093

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: 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 126change

Page 132: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS SEOUL MEDICAL GROUP

PRIMARY CARE PHYSICIANS

Internal Medicine

LOS ANGELES

90026

Filart, Marcel Adrian MD

1711 W Temple St Ste 1070

Los Angeles, CA 90026

(323) 499-1350

Provider ID: 128889

License: A76022

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.

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.

Hematology / Oncology

LAKEWOOD

90805

Cheung, Eric DO

3300 E South St Ste 304

Lakewood, CA 90805

(562) 262-0550

Provider ID: 74393

License: 20A9006

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Armenian,

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Ophthalmology

CITY OF INDUSTRY

91748

Wainess, Reid MD

17833 Colima Rd

City Of Industry, CA 91748

(323) 221-8000

Provider ID: 205312

License: A108766

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.

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 127change

Page 133: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS SEOUL MEDICAL GROUP

DOWNEY

90241

Suk, Kevin MD

11525 Brookshire Ave # 201a

Downey, CA 90241

(800) 898-2020

Provider ID: 70207

License: A114509

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Armenian,

Cantonese, Korean,

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.

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.

ENCINO

91316

Reznik, Alena MD

5353 Balboa Blvd Ste 110

Encino, CA 91316

(323) 644-4445

Provider ID: 248377

License: A113775

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.

UPDATE: NEW Provider Added.

Effective_Date: 04-FEB-20

Reznik, Jacob MD

5353 Balboa Blvd Ste 110

Encino, CA 91316

(323) 644-4445

Provider ID: 248109

License: A101891

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.

UPDATE: NEW Provider Added.

Effective_Date: 29-JAN-20

Varma, Rohit MD

5353 Balboa Blvd Ste 110

Encino, CA 91316

(323) 644-4445

Provider ID: 248449

License: A52885

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

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 128change

Page 134: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS SEOUL MEDICAL GROUP

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

90015

Gallemore, Ron MD

1414 S Grand Ave Ste 105

Los Angeles, CA 90015

(213) 749-5555

Provider ID: 103188

License: G78240

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Armenian,

Cantonese, Italian,

Japanese, Korean,

Mandarin, 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.

90020

Roe, Richard MD

505 S Virgil Ave Ste 300

Los Angeles, CA 90020

(213) 384-5222

Provider ID: 248243

License: A95880

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Armenian,

Korean, Mandarin, 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.

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.

90027

Varma, Rohit MD

1300 N Vermont Ave Ste 101

Los Angeles, CA 90027

(323) 644-4445

Provider ID: 242381

License: A52885

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.

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 129change

Page 135: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS SEOUL MEDICAL GROUP

panel status. (323) 221-6121 PTA: No

90031

Alasil, Tarek MD

2400 N Broadway

Los Angeles, CA 90031

(323) 221-6121

Provider ID: 245336

License: A108797

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Wainess, Reid MD

2400 N Broadway

Los Angeles, CA 90031

Provider ID: 70044

License: A108766

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

PASADENA

91105

Bedrood, Sahar MD

100 E California Blvd

Pasadena, CA 91105

(800) 898-2020

Provider ID: 243945

License: A124192

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Varma, Rohit MD

625 S Fair Oaks Ave

Pasadena, CA 91105

(323) 644-4445

Provider ID: 252335

License: A52885

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

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 130change

Page 136: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS SEOUL MEDICAL GROUP

accessibility indicators are not

present.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

POMONA

91767

Davis, Michael MD

160 E Artesia St Ste 120

Pomona, CA 91767

(800) 898-2020

Provider ID: 245774

License: A111866

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: 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.

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.

Vadrevu, Vijayalakshmi MD

160 E Artesia St Ste 120

Pomona, CA 91767

(909) 629-5965

Provider ID: 239327

License: C52114

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.

Optometrist

CITY OF INDUSTRY

91748

Tran, Henry OD

17833 Colima Rd

City Of Industry, CA 91748

(323) 221-8000

Provider ID: 244346

License: OPT15159

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; 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.

ENCINO

91316

Esfahani, Ora OD

5353 Balboa Blvd Ste 110

Encino, CA 91316

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 131change

Page 137: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS SEOUL MEDICAL GROUP

(323) 644-4445

Provider ID: 248316

License: OPT33522

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

French, 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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

LOS ANGELES

90027

Esfahani, Ora OD

1300 N Vermont Ave Ste 101

Los Angeles, CA 90027

(833) 270-3937

Provider ID: 248312

License: OPT33522

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Farsi,

French, 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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

SAN PEDRO

90732

Wong, Sharon OD

1360 W 6th St Ste 165

San Pedro, CA 90732

(800) 898-2020

Provider ID: 240486

License: OPT15137

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; 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.

TORRANCE

90505

Wong, Sharon OD

3440 Lomita Blvd Ste 100

Torrance, CA 90505

(800) 898-2020

Provider ID: 240487

License: OPT15137

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: B; 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

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 132change

Page 138: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS SEOUL MEDICAL GROUP

in the provider record;

demographic, phone and/or

panel status.

Pediatric Cardiology

PASADENA

91105

De Oliveira, Elizabeth MD

50 Bellefontaine St Ste 405

Pasadena, CA 91105

(626) 769-9259

Provider ID: 242100

License: C50168

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Armenian,

Farsi, German, 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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Urology

LOS ANGELES

90017

Kowalczyk, John DO

1127 Wilshire Blvd Ste 805

Los Angeles, CA 90017

(213) 670-7675

Provider ID: 246362

License: 20A6818

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Polish,

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.

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 133change

Page 139: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS TORRANCE HEALTH IPA

PRIMARY CARE PHYSICIANS

Family Practice

TORRANCE

90505

Yu, Michael MD

3333 Skypark Dr Ste 100

Torrance, CA 90505

(310) 784-6300

Provider ID: 70433

License: A80648

Credentials and/or board

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

CARSON

90745

Aguinaldo, Estrella MD

23517 Main St Ste 104

Carson, CA 90745

(310) 233-2555

Provider ID: 43485

License: A56493

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: Yes

Other Language: Samoan,

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.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

TORRANCE

90505

Khan, Sadia MD

3400 Lomita Blvd Ste 104

Torrance, CA 90505

(310) 784-8000

Provider ID: 252281

License: A113528

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.

UPDATE: NEW Provider Added.

Effective_Date: 07-FEB-20

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.

Obstetrics / Gynecology Internal Medicine

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

midwives CNS: Certified Nurse Specialists

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

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

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

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

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

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

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

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

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

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

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

completion of cultural competence training, and/or areas of training and experience. This list is subject to 134change

Page 140: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MEDICAL GROUPS TORRANCE HEALTH IPA

Djapri, Christine MD

3440 Lomita Blvd Ste 427

Torrance, CA 90505

(310) 325-9400

Provider ID: 248204

License: A138533

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Chinese,

Indonesian, 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.

Surgery Orthopedic

Striplin, Donald MD

23560 Crenshaw Blvd Ste 102

Torrance, CA 90505

(310) 784-2355

Provider ID: 253089

License: G75766

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.

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 135change

Page 141: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

AGOURA HILLS

91301

Vu, Hoang LAc;DOM

30200 Agoura Rd Ste 140

Agoura Hills, CA 91301

(818) 852-7159

www.doctorgu.com

License: AC16311

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 8AM-6PM, SA

8AM-2PM

PTA: No

Cultural Competency: NR

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.

ALHAMBRA

91801

Chang, Chung Young LAc

1000 S Garfield Ave

Alhambra, CA 91801

(626) 281-3383

www.TzuchiMedicalGroup.co

m

License: AC8360

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TU-SA 8AM-5PM

PTA: No

Other Language: Chinese

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Chen, Jeng-shiang LAc

1000 S Garfield Ave

Alhambra, CA 91801

(626) 281-3383

www.touchiclinics.org

License: AC10577

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TU-SA 8AM-5PM

PTA: No

Other Language: Mandarin

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Fu, Michael DC

1300 E Main St Ste 110

Alhambra, CA 91801

(626) 588-2101

License: DC25694

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 9:30AM-7PM, SA

9AM-1PM

PTA: No

Other Language: Mandarin

Cultural Competency: NR

Accessibility: P, EB, R, W;

Members should call the

provider’s office to discuss

their accessibility needs when

there is limited access or when

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

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

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

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

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

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

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

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

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

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

136

Page 142: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

accessibility indicators are not Lin, Chi-yi LAc Accepting New Members: Yes

present. 1000 S Garfield Ave Hours: TU-SA 8AM-5PM

UPDATE: There was a change Alhambra, CA 91801 PTA: No

in the provider record; (626) 281-3383 Other Language: Chinese,

demographic, phone and/or www.tzuchimedicalfoundatio Mandarin

panel status. n.org Cultural Competency: NR

License: AC8867 Accessibility: P, EB, R, W;

Credentials and/or board Members should call the

Lai, Yi-hsien LAc certification: No provider’s office to discuss

1000 S Garfield Ave Accepting New Members: Yes their accessibility needs when

Alhambra, CA 91801 Hours: TU-SA 8AM-5PM there is limited access or when

(626) 281-3383 PTA: No accessibility indicators are not

http://www.tzuchiclinics.org/ Other Language: Mandarin present.

License: AC8087 Cultural Competency: NR UPDATE: There was a change

Credentials and/or board Accessibility: P, EB, R, W; in the provider record;

certification: No Members should call the demographic, phone and/or

Accepting New Members: Yes provider’s office to discuss panel status.

Hours: TU-SA 8AM-5PM their accessibility needs when

PTA: No there is limited access or when

Other Language: Chinese accessibility indicators are not Wang, Chiao-nien LAc

Cultural Competency: NR present. 1000 S Garfield Ave

Accessibility: P, EB, R, W; UPDATE: There was a change Alhambra, CA 91801

Members should call the in the provider record; (626) 281-3383

provider’s office to discuss demographic, phone and/or www.tzuchimedicalgroup.co

their accessibility needs when panel status. m

there is limited access or when License: AC4403

accessibility indicators are not Credentials and/or board

present. Lin, Steven LAc certification: No

UPDATE: There was a change 1000 S Garfield Ave Accepting New Members: Yes

in the provider record; Alhambra, CA 91801 Hours: TU,TH-SA 8AM-5PM

demographic, phone and/or (626) 281-3383 PTA: No

panel status. License: AC14534 Other Language: Chinese,

Credentials and/or board Mandarin

certification: No Cultural Competency: NR

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

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

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

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

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

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

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

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

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

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

137

Page 143: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

Accessibility: P, EB, R, 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.

Zhao, Ming LAc

947 E Main St Ste A

Alhambra, CA 91801

(626) 421-7502

WWW.NATURALGOJI.COM

License: AC6045

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 10AM-5:30PM, SA

9:30AM-1PM

PTA: No

Other Language: Mandarin

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

91803

Mo, Solomon LAc

2140 W Valley Blvd

Alhambra, CA 91803

(626) 284-8881

www.solomonmo.com

License: 11598

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-W,F 10AM-4PM, SA

9:30AM-1PM

PTA: No

Other Language: Chinese,

Mandarin

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

ALTADENA

91001

Fong, Ryan LAc

2177 Lake Ave

Altadena, CA 91001

(323) 423-3061

www.fongacu.com

License: AC13791

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 9AM-5:30PM, SA

9AM-12:30PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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.

ARCADIA

91006

Cheng, Ya-wen DC

51 N 5th Ave Ste 305

Arcadia, CA 91006

(626) 292-6899

drcheng.net

License: DC27401

Credentials and/or board

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

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

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

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

138

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

certification: No Accessibility: P, EB, R, W; present.

Accepting New Members: Yes Members should call the UPDATE: There was a change

Hours: M,TH 9AM-7PM, F,SA provider’s office to discuss in the provider record;

8AM-2PM their accessibility needs when demographic, phone and/or

PTA: No there is limited access or when panel status.

Other Language: Spanish, accessibility indicators are not

Mandarin present.

Cultural Competency: NR UPDATE: There was a change Huang, Yung Ju LAc

Accessibility: P, EB, R, W; in the provider record; 115 E Live Oak Ave Ste 200

Members should call the demographic, phone and/or Arcadia, CA 91006

provider’s office to discuss panel status. (626) 674-4081

their accessibility needs when License: AC14492

there is limited access or when Credentials and/or board

accessibility indicators are not Feng, Charles DC certification: No

present. 202 S 1st Ave Accepting New Members: Yes

UPDATE: NEW Provider Added. Arcadia, CA 91006 Hours: M-F 9AM-5PM

Effective_Date: 01-MAR-20 (626) 447-4888 PTA: No

www.allprohealthcenter.com Other Language: Chinese,

License: DC29776 Mandarin

Chung Morita, Jonie DC Credentials and/or board Cultural Competency: NR

202 S 1st Ave certification: No Accessibility: P, EB, R, W;

Arcadia, CA 91006 Accepting New Members: Yes Members should call the

(626) 235-8818 Hours: M-F 9AM-6PM, SA provider’s office to discuss

https://betterhealthchiro.my-fr 8AM-1PM their accessibility needs when

ee.website/ PTA: No there is limited access or when

License: DC28353 Other Language: Chinese, accessibility indicators are not

Credentials and/or board Vietnamese, Mandarin present.

certification: No Cultural Competency: NR UPDATE: NEW Provider Added.

Accepting New Members: Yes Accessibility: P, EB, R, W; Effective_Date: 01-MAR-20

Hours: TU,TH 9AM-6:30PM, SA Members should call the

10AM-1PM provider’s office to discuss

PTA: No their accessibility needs when Zhang, Jackie LAc

Other Language: Chinese there is limited access or when 123 E Duarte Rd

Cultural Competency: NR accessibility indicators are not Arcadia, CA 91006

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

139

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

(626) 461-5337

License: AC14189

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 9AM-5PM, SA

9AM-2PM

PTA: No

Other Language: Chinese

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

91007

Wong, Thomas DC

612 W Duarte Rd Ste 306

Arcadia, CA 91007

(626) 623-6362

www.facebook.com/pages/c

ategory/Chiropractor/Dr-Th

License: DC30431

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,F 9AM-7PM, W

9AM-12PM, SA 2PM-8PM

PTA: No

Other Language: Mandarin

Cultural Competency: NR

Accessibility: P, EB, R, 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.

ARTESIA

90701

Lee, Yang-chau LAc

12225 South St Ste 105

Artesia, CA 90701

(562) 924-7238

www.AcucareAcupuncture.c

om

License: AC8362

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W-F 9AM-6PM, TU

2AM-6PM, SA 2AM-5PM

PTA: No

Other Language: Chinese

Cultural Competency: NR

Accessibility: P, EB, R, 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.

BALDWIN PARK

91706

Chen, Yuying LAc

3946 Maine Ave

Baldwin Park, CA 91706

(626) 672-0303

License: AC14906

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Other Language: Spanish,

Chinese, Mandarin,

Indonesian

Cultural Competency: NR

Members should call the

provider’s office to discuss

their accessibility needs.

UPDATE: There was a change

in the provider record;

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

140

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

demographic, phone and/or

panel status.

BELL GARDENS

90201

Lee, Soo LAc

6303 Eastern Ave

Bell Gardens, CA 90201

(323) 661-0900

License: AC4700

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TU,TH 10AM-5PM, SA

10AM-1PM

PTA: No

Other Language: Spanish,

Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Prieto, Enrique DC

8438 Eastern Ave

Bell Gardens, CA 90201

(562) 927-5453

Bebetterchiropractic.com

License: DC34264

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W,F 10AM-7PM, SA

9AM-12PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

BELLFLOWER

90706

Srisathapat, Amanda LAc

10000 Flower St

Bellflower, CA 90706

(562) 804-3449

License: AC17502

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 9AM-5PM, SA

9AM-12PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Wu, Jay LAc

10000 Flower St

Bellflower, CA 90706

(562) 804-3449

License: AC18639

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Other Language: Chinese

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

141

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

Effective_Date: 01-MAR-20

BURBANK

91504

Wood, Ron DC

1901 N Glenoaks Blvd Ste A

Burbank, CA 91504

(818) 557-1337

www.woodfamilychiropractic.

net

License: DC22897

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W,F 9AM-6PM, SA

9AM-12PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

91505

Kim, Sang Woo LAc

191 S Buena Vista St

Burbank, CA 91505

(818) 561-4733

License: AC9487

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W,F 9AM-6PM

PTA: No

Other Language: Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

91506

Ho, Diep LAc

2300 W Victory Blvd Ste E

Burbank, CA 91506

(626) 576-4644

License: AC4732

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: SU 9AM-2PM, TU,TH

9AM-7PM

PTA: No

Other Language: Vietnamese

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Lee, In Sook LAc

2300 W Victory Blvd Ste E

Burbank, CA 91506

(818) 805-6084

License: AC7030

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: SU 10AM-4PM, M-W,F

9AM-5PM, TH 9AM-8PM

PTA: No

Other Language: Spanish,

Korean

Cultural Competency: NR

Accessibility: P, EB, R, W;

Members should call the

provider’s office to discuss

their accessibility needs when

there is limited access or when

accessibility indicators are not

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

142

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

present.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

St Juste, Carlo LAc

1220 W Olive Ave

Burbank, CA 91506

(818) 848-2225

www.csjacupuncture.com

License: AC14551

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,F 8AM-11AM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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.

CALABASAS

91302

Long, Billy DC

24007 Ventura Blvd Ste 130

Calabasas, CA 91302

(818) 591-8847

www.longcommunitychiro.co

m

License: DC27936

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W,F 9AM-6PM, TU,TH

2:30PM-6:30PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

CANYON COUNTRY

91387

Kim, A Young LAc

18261 Soledad Canyon Rd

Canyon Country, CA 91387

(661) 251-5930

www.kiacupuncture.com

License: AC10599

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W,F 9AM-6PM, TU,TH

9AM-12PM, SA 9AM-1PM

PTA: No

Other Language: Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Sanchez, Rodrigo DC

18500 Via Princessa Ste 3

Canyon Country, CA 91387

(661) 940-7171

License: DC26487

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: P, EB, R, W;

Members should call the

provider’s office to discuss

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

143

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

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.

CERRITOS

90703

Lee-shim, Eun Seon LAc

13337 South St Ste 558

Cerritos, CA 90703

(714) 249-5553

License: AC6287

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Other Language: Korean

Cultural Competency: NR

Members should call the

provider’s office to discuss

their accessibility needs.

UPDATE: NEW Provider Added.

Effective_Date: 01-MAR-20

Lee, Kyounghee LAc

13209 South St

Cerritos, CA 90703

(562) 402-5252

License: 11678

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Other Language: Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Odvina, Rheamay DC

11341 183rd St

Cerritos, CA 90703

(562) 474-1809

www.themommadoc.com

License: DC33942

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-W 9AM-7PM, F

9AM-5PM

PTA: No

Other Language: Tagalog

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Park, Dae LAc

18331 Gridley Rd Ste C

Cerritos, CA 90703

(562) 787-6730

License: AC6077

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Other Language: Korean

Cultural Competency: NR

Accessibility: P, EB, R, W;

Members should call the

provider’s office to discuss

their accessibility needs when

there is limited access or when

accessibility indicators are not

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

144

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

present.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

CITY OF INDUSTRY

91745

Pham, Tung LAc

15221 Gale Ave

City Of Industry, CA 91745

(626) 626-5567

License: AC15439

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M 3PM-7PM, W,TH

1PM-7PM, F 10AM-2PM

PTA: No

Other Language: Spanish,

Vietnamese, Mandarin

Cultural Competency: NR

Accessibility: P, EB, R, 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.

91748

Fu, Michael DC

1661 Hanover Rd Ste 225

City Of Industry, CA 91748

(626) 810-8143

License: DC25694

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TU,TH 10AM-7PM, F

2PM-7PM, SA 10AM-1PM

PTA: No

Other Language: Mandarin

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Hong, Sung Hee LAc

17595 Almahurst St Ste 100b

City Of Industry, CA 91748

(626) 363-4383

License: 15700

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 10AM-6PM

PTA: No

Other Language: Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Hong, Sung Hee DC

17595 Almahurst St Ste 100b

City Of Industry, CA 91748

(626) 363-4383

License: DC32324

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 10AM-6PM, SA

10AM-2PM

PTA: No

Other Language: Korean

Cultural Competency: NR

Accessibility: P, EB, R, W;

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

145

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

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.

Yin, Li DC

18575 Gale Ave Ste 265

City Of Industry, CA 91748

(626) 623-8684

License: DC34115

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-W,F 9AM-7PM, TH,SA

9AM-1PM

PTA: No

Other Language: Mandarin

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

CLAREMONT

91711

Lee, Li Hung LAc

226 1/2 W Foothill Blvd

Claremont, CA 91711

(818) 928-5338

www.lighthouse68acu.com

License: AC16179

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 9:30AM-5PM, SA

9:30AM-1PM

PTA: No

Other Language: Spanish,

Chinese

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

COVINA

91723

Joukar, Mehrdad LAc;DOM

275 W San Bernardino Rd

Covina, CA 91723

(626) 967-3553

www.MehrdadJoukar.com

License: AC15905

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: No

Other Language: Persian

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Miller, Soo LAc;DOM

275 W San Bernardino Rd

Covina, CA 91723

(626) 967-3553

License: AC9146

Credentials and/or board

certification: No

Accepting New Members: Yes

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

146

Page 152: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

Hours: M 2PM-5:30PM, F

9AM-1PM

PTA: No

Other Language: Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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

Chung Morita, Jonie DC

1130 S Diamond Bar Blvd

Diamond Bar, CA 91765

(909) 860-1661

http://betterhealthchiro.my-fr

ee.website/

License: DC28353

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W,F 9AM-6:30PM,

TU,SA 10AM-1PM

PTA: No

Other Language: Chinese

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Siegel, Gregory DC

566 N Diamond Bar Blvd

Diamond Bar, CA 91765

(562) 945-1310

License: DC15681

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TU 2PM-6:30PM, TH

1:30PM-6:30PM, SA 11AM-3PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: P, EB, R, 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.

DOWNEY

90240

Huynh, Tran LAc

8358 Florence Ave

Downey, CA 90240

(562) 622-4444

www.moralesholistic.com

License: 18362

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W,F 9AM-7PM, TU,TH

10AM-7PM

PTA: No

Other Language: Vietnamese

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Lee, Jason LAc

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

147

Page 153: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

8358 Florence Ave

Downey, CA 90240

(562) 622-4444

www.moralesholistic.com

License: AC18030

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W,F 9AM-7PM, TU,TH

10AM-7PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Lee, Jason DC

8358 Florence Ave

Downey, CA 90240

(562) 622-4444

www.moralesholistic.com

License: DC33980

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W,F 9AM-7PM, TU,TH

10AM-7PM

PTA: No

Other Language: Mandarin

Cultural Competency: NR

Accessibility: P, EB, R, 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.

90241

Lee, Jin LAc

11422 Old River School Rd

Downey, CA 90241

(562) 928-8969

License: 17961

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,TU,TH,F 9AM-5PM, SA

9AM-12PM

PTA: No

Other Language: Korean

Cultural Competency: NR

Accessibility: P, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Zarrabi, Cathrine DC

11820 Downey Ave

Downey, CA 90241

(562) 927-1116

www.zarrabichiro.com

License: DC23415

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W 9AM-7PM, TU,TH

2PM-7PM, F 9AM-1PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

148

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

90242

Bao, Tien DC

12115 Paramount Blvd

Downey, CA 90242

(562) 250-2002

License: DC27009

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 9AM-6PM

PTA: No

Other Language: Vietnamese

Cultural Competency: NR

Accessibility: P, EB, R, 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.

DUARTE

91010

Mchaney, John DC

924 Buena Vista St Ste 103

Duarte, CA 91010

(626) 359-3956

www.duartechiropractic.com

License: DC29560

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W 10AM-7PM,

TU,TH-SA 10AM-2PM

PTA: No

Other Language: Spanish,

Persian, Classical Armenian

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

EAGLE ROCK

90041

Tajyar, Amber LAc

2501 Colorado Blvd Ste E

Eagle Rock, CA 90041

(323) 687-3222

License: AC4905

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: F 1AM-7PM

PTA: No

Other Language: Persian

Cultural Competency: NR

Accessibility: P, EB, R, 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.

EL MONTE

91731

Cade, Charlene LAc

10119 Valley Blvd

El Monte, CA 91731

(323) 226-0188

www.bencaotang.org

License: AC7326

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 9AM-6PM, SA

9AM-2PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, W;

Members should call the

provider’s office to discuss

their accessibility needs when

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

149

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

there is limited access or when

accessibility indicators are not

present.

UPDATE: NEW Provider Added.

Effective_Date: 01-MAR-20

Kwon, Sang Hyeuk LAc

10933 Main St Unit D7

El Monte, CA 91731

(626) 442-1321

License: AC18392

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M 10AM-6:30PM, W-F

10AM-7PM, SA 10AM-5PM

PTA: No

Other Language: Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Lee, Soo LAc

10958 Ramona Blvd

El Monte, CA 91731

(323) 661-0900

License: AC4700

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TU,TH 10AM-5PM, SA

10AM-1PM

PTA: No

Other Language: Spanish,

Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

91733

Chen, Yuying LAc

10349 Garvey Ave

El Monte, CA 91733

(626) 672-0303

License: AC14906

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Other Language: Spanish,

Chinese, Mandarin,

Indonesian

Cultural Competency: NR

Accessibility: P, EB, R, 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.

ENCINO

91316

Bui, Tan DC

5435 Balboa Blvd Ste 207

Encino, CA 91316

(818) 650-8081

License: DC32021

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 8AM-6PM, SA

8AM-12PM

PTA: No

Cultural Competency: NR

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

150

Page 156: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

91436

Kim, Young LAc

16250 Ventura Blvd Ste 450

Encino, CA 91436

(818) 809-1009

www.abcherb.com

License: AC17165

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-7PM

PTA: No

Other Language: Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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.

GARDENA

90247

Choi, Ki LAc;DOM

2015 W Redondo Beach Blvd

Ste F

Gardena, CA 90247

(424) 340-9357

License: AC17012

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Other Language: Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Jung, Ji Hwan LAc

1251 W Redondo Beach Blvd

Fl 3

Gardena, CA 90247

(310) 965-0500

License: AC14041

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Other Language: Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Kim, Daniel LAc

2015 W Redondo Beach Blvd

Ste F

Gardena, CA 90247

(424) 340-9357

License: AC13813

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

151

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

Other Language: Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Kim, William June-ki LAc

2015 W Redondo Beach Blvd

Ste F

Gardena, CA 90247

(424) 340-9357

License: AC5763

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W-F 9:30AM-6:30PM,

TU 9:30AM-6PM, SA

9:30AM-3:30PM

PTA: No

Other Language: Spanish,

Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Oh, Meesuk LAc

2015 W Redondo Beach Blvd

Ste F

Gardena, CA 90247

(424) 340-9357

License: AC17055

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W-F 9:30AM-6:30PM,

TU 9AM-6:30PM, SA

9:30AM-3:30PM

PTA: No

Other Language: Spanish,

Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Oh, Se Yeong LAc

2015 W Redondo Beach Blvd

Ste F

Gardena, CA 90247

(424) 340-9357

danielacu.com

License: AC10176

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 9:30AM-6:30PM, SA

9:30AM-3:30PM

PTA: No

Other Language: Spanish,

Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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.

GLENDALE

91201

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

152

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

Frame, Katherine LAc

1620 Victory Blvd

Glendale, CA 91201

(818) 244-7600

glendalechirocare.com

License: 13647

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 9AM-5:30PM, SA

8AM-1PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

91202

Choe, Dong DC

1111 N Brand Blvd Ste 402

Glendale, CA 91202

(818) 243-6206

www.gkchiro.com

License: DC30548

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,TU,TH 9AM-6PM, W,SA

9AM-2PM, F 9AM-1PM

PTA: No

Other Language: Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

91203

Joukar, Mehrdad LAc;DOM

411 N Central Ave Ste 610

Glendale, CA 91203

(818) 244-6792

www.MehrdadJoukar.com

License: AC15905

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: No

Other Language: Persian

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Miller, Soo LAc;DOM

411 N Central Ave Ste 610

Glendale, CA 91203

(818) 244-6792

License: AC9146

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M 9AM-1PM, F

1:30PM-5:30PM

PTA: No

Other Language: Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

153

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

91204

Canabal, Manuel LAc

1220 S Central Ave Ste 104

Glendale, CA 91204

(818) 240-7511

License: AC12605

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TU,TH 8AM-1:30PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Yaghjian, Ara DC

706 W Broadway Ste 100

Glendale, CA 91204

(818) 247-9097

License: DC14289

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W,F 4PM-6PM, TU,TH

10AM-12PM

PTA: No

Other Language: Arabic,

Classical Armenian

Cultural Competency: NR

Accessibility: P, EB, R, 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.

91205

Mesrkhani, Razmik DC

520 E Broadway Ste 302

Glendale, CA 91205

(818) 247-3118

www.oxfordhealth4u.com

License: DC23910

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Other Language: Persian,

Classical Armenian

Cultural Competency: NR

Members should call the

provider’s office to discuss

their accessibility needs.

UPDATE: NEW Provider Added.

Effective_Date: 01-MAR-20

91208

Jacobs, Bruce DC

3510 1/2 Ocean View Blvd

Glendale, CA 91208

(818) 248-0887

License: DC22375

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W,F 9AM-6PM

PTA: No

Cultural Competency: NR

Accessibility: EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Lee, In Sook LAc

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

154

Page 160: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

1808 Verdugo Blvd Ste 319

Glendale, CA 91208

(818) 805-6084

License: AC7030

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: SU 10AM-4PM, M-F

9AM-5PM

PTA: No

Other Language: Spanish,

Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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.

GLENDORA

91740

Doty, Brian LAc

1135 E Route 66 Ste 106

Glendora, CA 91740

(626) 382-9715

GlendoraAcupuncture.com

License: AC9049

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W,F 9AM-12PM, TU,TH

12:15PM-8PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Doty, Brian LAc

2060 E Route 66 Ste 201

Glendora, CA 91740

(626) 382-9715

GlendoraAcupuncture.com

License: AC9049

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M 12:15PM-7PM, TU,TH

9AM-12PM, W 12:15PM-8PM, F

12:15PM-6PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Garay, Jose DC

2220 E Route 66 Ste 225

Glendora, CA 91740

(626) 914-5881

License: DC34320

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

155

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

Effective_Date: 01-MAR-20

91741

Choi, Jungsook LAc

640 W Foothill Blvd Ste 101

Glendora, CA 91741

(323) 877-6420

License: 11712

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Other Language: Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Garay, Jose DC

230 N Glendora Ave

Glendora, CA 91741

(626) 914-5881

License: DC34320

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-TH 9AM-6PM, F

9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Seok, Puchun LAc

242 S Glendora Ave

Glendora, CA 91741

(626) 335-1918

License: AC11582

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 9AM-5PM, SA

9AM-3PM

PTA: No

Other Language: Spanish,

Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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.

GRANADA HILLS

91344

Liptawat, Jennifer LAc

10515 Balboa Blvd Ste 355

Granada Hills, CA 91344

(818) 360-0025

License: 18409

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 9AM-6PM

PTA: No

Other Language: Vietnamese

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

156

Page 162: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

HACIENDA HEIGHTS

91745

Fu, Rongpin LAc

2373 S Hacienda Blvd

Hacienda Heights, CA 91745

(626) 977-9188

License: 18012

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5:30PM

PTA: No

Other Language: Chinese

Cultural Competency: NR

Accessibility: P, EB, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Hong, Zhen-li LAc

2020 S Hacienda Blvd Ste D

Hacienda Heights, CA 91745

(626) 855-1158

License: AC5692

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 9AM-7PM, SA

8:30AM-1PM

PTA: No

Other Language: Mandarin

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Huang, Yung Ju LAc

3150 Colima Rd Ste C

Hacienda Heights, CA 91745

(626) 674-4081

License: AC14492

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TU,TH 1PM-6PM

PTA: No

Other Language: Chinese,

Mandarin

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Huo, Wayne LAc

2020 S Hacienda Blvd Ste D

Hacienda Heights, CA 91745

(626) 855-1158

License: AC16081

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 9AM-7PM, SA

8:30AM-1PM

PTA: No

Other Language: Mandarin

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

157

Page 163: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

Liaw, Yih-jenn LAc

1617 S Azusa Ave

Hacienda Heights, CA 91745

(323) 616-8555

License: AC4599

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Other Language: Chinese

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Lin, Charles DC

2020 S Hacienda Blvd Ste D

Hacienda Heights, CA 91745

(626) 855-1158

License: DC26220

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 9AM-7PM, SA

8:30AM-1PM

PTA: No

Other Language: Mandarin

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Lu, Yang LAc

2020 S Hacienda Blvd Ste D

Hacienda Heights, CA 91745

(626) 855-1558

License: AC18057

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 9AM-7PM, SA

8:30AM-2PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Yang, Jor Hwa Lin LAc

16404 Colima Rd 1st Fl

Hacienda Heights, CA 91745

(626) 617-6341

License: AC08282

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 9AM-5PM

PTA: No

Other Language: Mandarin

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

HAWTHORNE

90250

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

158

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

Hogan, James DC

5400 W Rosecrans Ave

Hawthorne, CA 90250

(310) 699-9299

License: DC30436

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

HERMOSA BEACH

90254

Son, Jong Soo LAc

555 Pier Ave Ste 1

Hermosa Beach, CA 90254

(800) 385-1130

www.elimacu.com

License: 13324

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Other Language: Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

HUNTINGTON PARK

90255

Kim, Don LAc

7128 Pacific Blvd Ste H

Huntington Park, CA 90255

(615) 573-0277

License: AC08476

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Other Language: Spanish,

Korean

Cultural Competency: NR

Members should call the

provider’s office to discuss

their accessibility needs.

UPDATE: NEW Provider Added.

Effective_Date: 01-MAR-20

IRWINDALE

91706

Oh, Ruth LAc

5345 Irwindale Ave

Irwindale, CA 91706

(626) 960-5361

www.healthpointe.net

License: 07498

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SU 8AM-6PM

PTA: No

Other Language: Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

LA CANADA FLINTRIDGE

91011

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

159

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

Kim, Seog DC

1039 Foothill Blvd

La Canada Flintridge, CA

91011

(818) 790-4011

License: DC27463

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Other Language: Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

LAKEWOOD

90712

Feng, Charles DC

5220 Clark Ave Ste 445

Lakewood, CA 90712

(562) 867-6183

www.allprohealthcenter.com

License: DC29776

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 9AM-6PM, SA

8AM-1PM

PTA: No

Other Language: Chinese,

Vietnamese, Mandarin

Cultural Competency: NR

Accessibility: P, EB, R, 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.

LANCASTER

93534

Bracamontes, Raymond DC

42283 10th St W Ste 107

Lancaster, CA 93534

(661) 949-9655

www.fryechiropractic.com

License: DC25551

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W 8AM-7PM, TU,TH

3PM-7PM, F 8AM-12PM, SA

8AM-9AM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Mooney, Andrew DC

412 W Avenue J Ste F

Lancaster, CA 93534

(818) 830-0027

License: DC29078

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,TU,TH 9AM-5PM, W

9AM-2PM, F 9AM-12PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: P, EB, R, W;

Members should call the

provider’s office to discuss

their accessibility needs when

there is limited access or when

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

160

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

accessibility indicators are not

present.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Sanchez, Rodrigo DC

42544 10th St W Ste G

Lancaster, CA 93534

(661) 940-7171

License: DC26487

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W 8AM-6PM, TU,TH

9AM-5PM, F 8AM-3PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: P, EB, R, 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.

LAWNDALE

90260

Zarrabi, Cathrine DC

15725 Hawthorne Blvd Ste 106

Lawndale, CA 90260

(310) 650-9068

www.zarrabichiro.com

License: DC23415

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W 9AM-7PM, TU,TH

2PM-7PM, F 9AM-1PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: P, EB, R, 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.

LOMITA

90717

Shin, Youn Jung LAc

2040 Pacific Coast Hwy Ste R

Lomita, CA 90717

(310) 257-9080

License: AC12368

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,SA 9AM-1PM, TU,W,F

9AM-6PM

PTA: No

Other Language: Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

LONG BEACH

90802

Park, Jea Young LAc

57 Long Beach Blvd

Long Beach, CA 90802

(562) 436-8881

purewaveacupuncture.com

License: AC10228

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,TU,TH,F 2PM-7PM, W

10AM-2PM

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

161

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

PTA: No

Other Language: Spanish,

Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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.

90803

Lin, Steven LAc

5855 E Naples Plz Ste 111

Long Beach, CA 90803

(562) 888-3399

License: AC14534

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M 10AM-5PM

PTA: No

Other Language: Chinese,

Mandarin

Cultural Competency: NR

Accessibility: P, EB, R, 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.

90806

Uong, Rene DC

2760 E Spring St Ste 150

Long Beach, CA 90806

(562) 424-1200

License: DC28752

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-7PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

90807

Butts, Myron LAc

4028 Long Beach Blvd Ste 202

Long Beach, CA 90807

(562) 981-0555

License: AC12860

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W,F,SA 8AM-6PM,

TU,TH 10AM-6PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Butts, Myron DC

4028 Long Beach Blvd Ste 202

Long Beach, CA 90807

(562) 981-0555

License: DC30680

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W,F,SA 8AM-6PM,

TU,TH 10AM-6PM

PTA: No

Cultural Competency: NR

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

162

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

Accessibility: P, EB, R, W; Long, Mary LAc Hours: M,TU,TH,F 9:30AM-6PM

Members should call the 4301 Atlantic Ave Ste 5 PTA: No

provider’s office to discuss Long Beach, CA 90807 Other Language: Japanese

their accessibility needs when (562) 888-9933 Cultural Competency: NR

there is limited access or when drmarylong.wixsite.com/acup Accessibility: P, EB, R, W;

accessibility indicators are not uncture Members should call the

present. License: AC18298 provider’s office to discuss

UPDATE: NEW Provider Added. Credentials and/or board their accessibility needs when

Effective_Date: 01-MAR-20 certification: No there is limited access or when

Accepting New Members: Yes accessibility indicators are not

Hours: TU,W 9AM-6PM, TH present.

Johnson, Brock DC 10AM-6:30PM, F 9AM-12PM, SA UPDATE: NEW Provider Added.

3505 Long Beach Blvd Ste 1d 9AM-11:30AM Effective_Date: 01-MAR-20

Long Beach, CA 90807 PTA: No

(562) 912-4225 Cultural Competency: NR

License: DC30300 Accessibility: P, EB, R, W; Wang, Yang LAc

Credentials and/or board Members should call the 3505 Long Beach Blvd Ste 2d

certification: No provider’s office to discuss Long Beach, CA 90807

Accepting New Members: Yes their accessibility needs when (562) 424-5505

Hours: M,W,F,SA 9AM-5PM, there is limited access or when www.simplehealthlb.com

TU,TH 12PM-8PM accessibility indicators are not License: 18654

PTA: No present. Credentials and/or board

Cultural Competency: NR UPDATE: NEW Provider Added. certification: No

Accessibility: P, EB, R, W; Effective_Date: 01-MAR-20 Accepting New Members: Yes

Members should call the Hours: Contact facility for

provider’s office to discuss hours of operation

their accessibility needs when Nomura, Yoko LAc PTA: No

there is limited access or when 3490 Linden Ave Ste 3 Other Language: Mandarin

accessibility indicators are not Long Beach, CA 90807 Cultural Competency: NR

present. (310) 920-8761 Accessibility: P, EB, R, W;

UPDATE: NEW Provider Added. License: AC16988 Members should call the

Effective_Date: 01-MAR-20 Credentials and/or board provider’s office to discuss

certification: No their accessibility needs when

Accepting New Members: Yes there is limited access or when

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

163

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

accessibility indicators are not

present.

UPDATE: NEW Provider Added.

Effective_Date: 01-MAR-20

90808

Eskilson, Emma DC

3816 Woodruff Ave Ste 202

Long Beach, CA 90808

(562) 420-5433

License: DC34631

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

90813

Yeganeh Hajahmadi,

Mahmoud LAc

980 Atlantic Ave Fl 3

Long Beach, CA 90813

(562) 624-0776

License: AC15561

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 9AM-5PM

PTA: No

Other Language: Persian

Cultural Competency: NR

Accessibility: P, EB, R, 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.

90815

Blakely, David DC

2220 Clark Ave

Long Beach, CA 90815

(562) 597-4181

License: DC13938

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: EB, 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.

Dawson, Jonathan DC

5512 E Britton Dr Ste 100

Long Beach, CA 90815

(949) 600-7988

www.lifechoicewellnesscenter

.com

License: DC32839

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, W;

Members should call the

provider’s office to discuss

their accessibility needs when

there is limited access or when

accessibility indicators are not

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

164

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

present.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Lin, Steven LAc

2700 N Bellflower Blvd Ste 116

Long Beach, CA 90815

(562) 888-3399

License: AC14534

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TH 10AM-5PM

PTA: No

Other Language: Chinese,

Mandarin

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Lorenzo, Keola DC

2221 Palo Verde Ave Ste 1j

Long Beach, CA 90815

(562) 795-7007

healthatlastusa.com/longbea

ch

License: DC34469

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W 8AM-5PM, TU,TH

8AM-6PM, F 7AM-4PM, SA

8AM-1PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

LOS ANGELES

90005

Kim, Chul Un LAc

711 S Vermont Ave Ste 113

Los Angeles, CA 90005

(213) 718-2115

License: 12738

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SU 8AM-8PM

PTA: No

Other Language: Japanese,

Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Lee, Jay LAc

680 Wilshire Pl Ste 312

Los Angeles, CA 90005

(213) 268-7838

www.happymind4you.com

License: AC13859

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,TU,TH,F 9AM-6PM, W

2PM-6PM

PTA: No

Other Language: Korean

Cultural Competency: NR

Accessibility: P, EB, R, W;

Members should call the

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

165

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

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-MAR-20

90006

Chuang, Gina Hua Qin LAc

2140 W Olympic Blvd Ste 200

Los Angeles, CA 90006

(213) 804-1684

License: AC7175

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W,F 8AM-2PM,

TU,TH,SA 8AM-6PM

PTA: No

Other Language: Chinese,

Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Kim, William June-ki LAc

1940 W Olympic Blvd

Los Angeles, CA 90006

(213) 389-3929

License: AC5763

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 9AM-6PM, SA

9AM-4PM

PTA: No

Other Language: Spanish,

Korean

Cultural Competency: NR

Accessibility: P, R, 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.

Lee, Miran LAc

3030 W Olympic Blvd Ste 201

Los Angeles, CA 90006

(213) 399-8575

License: AC10233

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Other Language: Spanish,

Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Oh, Se Yeong LAc

1940 W Olympic Blvd

Los Angeles, CA 90006

(213) 389-3929

License: AC10176

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 9AM-6PM, SA

9AM-3PM

PTA: No

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

166

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

Other Language: Spanish,

Korean

Cultural Competency: NR

Accessibility: P, R, 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.

Ryu, Hu Ki LAc

2655 W Olympic Blvd Ste 205

Los Angeles, CA 90006

(213) 820-6040

hillsacupuncture.com

License: AC10645

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M 10AM-6PM, W,F

9AM-6PM

PTA: No

Other Language: Chinese,

Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Son, Jong Soo LAc

2897 W Olympic Blvd Ste 202

Los Angeles, CA 90006

(800) 385-1130

www.elimacu.com

License: 13324

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,SA 9AM-6PM

PTA: No

Other Language: Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Woo, Young Uk LAc

1940 W Olympic Blvd

Los Angeles, CA 90006

(213) 389-3929

License: 10267

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-TH 9AM-6PM, SA

9AM-1PM

PTA: No

Other Language: Korean

Cultural Competency: NR

Members should call the

provider’s office to discuss

their accessibility needs.

UPDATE: NEW Provider Added.

Effective_Date: 01-MAR-20

90007

Lee, Miran LAc

2716 S Vermont Ave Ste 1

Los Angeles, CA 90007

(213) 399-8575

License: AC10233

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,TU,SA 9AM-12PM,

W,TH 9AM-5PM

PTA: No

Other Language: Spanish,

Korean

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

167

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

90010

Cho, Eun LAc

3020 Wilshire Blvd Ste 222

Los Angeles, CA 90010

(213) 389-3003

www.okbalance.com

License: AC12268

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W,F 10AM-6PM, SA

10AM-3PM

PTA: No

Other Language: Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Jung, Inho LAc

3545 Wilshire Blvd Ste 210

Los Angeles, CA 90010

(213) 605-1133

www.jungacupuncturegroup.

com

License: AC16791

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TU,TH 9:30AM-6:30PM

PTA: No

Other Language: Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Park, Jae LAc

3020 Wilshire Blvd Ste 222

Los Angeles, CA 90010

(213) 389-3003

License: AC11917

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W,F 10AM-6PM, SA

10AM-3PM

PTA: No

Other Language: Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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.

90019

Choi, Soyoung LAc

1550 4th Ave

Los Angeles, CA 90019

(562) 373-6650

www.choyacu.com

License: AC17409

Credentials and/or board

certification: No

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

168

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

Accepting New Members: Yes

Hours: M-F 9AM-6PM, SA

9AM-2PM

PTA: No

Other Language: Spanish,

Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Chung, Wanmi LAc

1723 S Bronson Ave

Los Angeles, CA 90019

(323) 854-8814

License: 18445

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 9AM-6PM

PTA: No

Other Language: Korean

Cultural Competency: NR

Members should call the

provider’s office to discuss

their accessibility needs.

UPDATE: NEW Provider Added.

Effective_Date: 01-MAR-20

Kim, Jae LAc

3400 W Olympic Blvd

Los Angeles, CA 90019

(213) 365-2277

License: AC4989

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 9AM-6PM, SA

9AM-3PM

PTA: No

Other Language: Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Lee, Yun Soo LAc

903 Crenshaw Blvd Ste 206b

Los Angeles, CA 90019

(888) 600-2545

License: AC11273

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-6PM

PTA: No

Other Language: Spanish,

Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Sin, Sun LAc

4077 W Pico Blvd

Los Angeles, CA 90019

(323) 733-0471

villagehealthfdn.org

License: AC9079

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TU-SA 9AM-5PM

PTA: No

Other Language: Korean

Cultural Competency: NR

Accessibility: P, EB, R, W;

Members should call the

provider’s office to discuss

their accessibility needs when

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

169

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

there is limited access or when

accessibility indicators are not

present.

UPDATE: NEW Provider Added.

Effective_Date: 01-MAR-20

90020

Hea, Jean DC

505 Shatto Pl Ste 200a

Los Angeles, CA 90020

(213) 800-3992

License: DC29584

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-TH 10AM-6PM, F

10AM-1PM

PTA: No

Other Language: Spanish,

Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Joung, Junkyoung LAc

505 Shatto Pl Ste 200a

Los Angeles, CA 90020

(213) 277-1830

License: AC4907

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Other Language: Spanish,

Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Kim, Chel LAc

520 S Virgil Ave Ste 503

Los Angeles, CA 90020

(323) 677-4900

www.jasengusa.com

License: AC11202

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,TU,TH,F 9AM-6PM,

W,SA 9AM-1PM

PTA: No

Other Language: Chinese,

Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Yang, Min Ho LAc

4220 W 3rd St Ste 205

Los Angeles, CA 90020

(213) 718-2259

www.acussinsa.com

License: AC13742

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-6PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, W;

Members should call the

provider’s office to discuss

their accessibility needs when

there is limited access or when

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

170

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

accessibility indicators are not

present.

UPDATE: NEW Provider Added.

Effective_Date: 01-MAR-20

90023

Garcia, Jennifer LAc

810 S Indiana St

Los Angeles, CA 90023

(323) 835-7404

www.jennygarciaacupunctur

e.com

License: AC17088

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TU,TH,F 10AM-7PM

PTA: No

Other Language: Spanish,

Portuguese

Cultural Competency: NR

Accessibility: P, EB, R, 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.

90024

Goel, Nadia DC

1722 Westwood Blvd Ste 201

Los Angeles, CA 90024

(310) 441-4000

www.drnadiagoel.com

License: DC26550

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W,F 9AM-5PM, TU,TH

2PM-5PM

PTA: No

Other Language: Persian

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Hogan, James DC

10960 Wilshire Blvd

Los Angeles, CA 90024

(310) 699-9299

www.activebodychirocare.co

m

License: DC30436

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Kim, William June-ki LAc

1008 Broxton Ave

Los Angeles, CA 90024

(424) 248-3115

License: AC5763

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 10AM-7PM

PTA: No

Other Language: Spanish,

Korean

Cultural Competency: NR

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

171

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

Accessibility: P, EB, R, 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.

Oh, Meesuk LAc

1008 Broxton Ave

Los Angeles, CA 90024

(424) 248-3115

License: AC17055

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 10AM-7PM

PTA: No

Other Language: Spanish,

Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Oh, Se Yeong LAc

1008 Broxton Ave

Los Angeles, CA 90024

(424) 248-3115

danielacu.com

License: AC10176

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-W,F 10AM-7PM, SA

10AM-3PM

PTA: No

Other Language: Spanish,

Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Tabibian, Roya DC

1762 Westwood Blvd Ste 110

Los Angeles, CA 90024

(310) 202-2100

doctabibian.com

License: DC25185

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 8AM-7PM, SA

8AM-1PM

PTA: No

Other Language: Persian

Cultural Competency: NR

Accessibility: P, EB, R, 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.

90025

Chung, Anthony LAc

1840 Westwood Blvd

Los Angeles, CA 90025

(310) 473-5533

License: AC8960

Credentials and/or board

certification: No

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

172

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

Accepting New Members: Yes

Hours: M-SU 10AM-10PM

PTA: No

Other Language: Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Evans, Sanae LAc

2001 S Barrington Ave Ste 118

Los Angeles, CA 90025

(657) 206-7262

SanaLAcWellness.com

License: 17631

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TH,SU 9AM-5PM

PTA: No

Other Language: Japanese

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Ide, Nobuko LAc

1976 S Sepulveda Blvd

Los Angeles, CA 90025

(310) 421-8405

www.nobukoacu.com

License: 14934

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,TH 1PM-6PM, TU

3PM-6PM, W,F 8AM-6PM, SA

12PM-6PM

PTA: No

Other Language: Japanese

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Kimia, Roy LAc

11540 Santa Monica Blvd Ste

203

Los Angeles, CA 90025

(424) 274-2632

www.kimiawellness.com

License: AC17546

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: SU 3PM-7PM, M-TH

8AM-7PM, F 8AM-3PM

PTA: No

Other Language: Persian,

Hebrew

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Lin, Yu-chen LAc

2130 Sawtelle Blvd Ste 306

Los Angeles, CA 90025

(310) 477-5899

License: AC4836

Credentials and/or board

certification: No

Accepting New Members: Yes

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

173

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130

LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

Hours: TU,TH 10:30AM-8PM, SA

10AM-6PM

PTA: No

Other Language: Chinese,

Mandarin, Japanese

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Li, Jack DC

12340 Santa Monica Blvd Ste

Los Angeles, CA 90025

(310) 207-1007

http://www.drjacklidc.com

License: DC31142

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TU 10AM-7PM, TH

10:30AM-7PM, SA 9AM-3PM

PTA: No

Other Language: Spanish,

Chinese, Vietnamese

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

90026

Reinherz, Ira DC

120 N Alvarado St

Los Angeles, CA 90026

(213) 353-0200

License: DC18605

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 8:30AM-5PM, SA

8:30AM-1PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

90027

Quach, Sarika LAc

4443 Ambrose Ave

Los Angeles, CA 90027

(213) 600-8288

www.somaacuwellness.com

License: 18440

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TU-SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: R, 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.

90028

Seo, Jung Eun LAc

1601 N Gower St Ste 103

Los Angeles, CA 90028

(323) 247-9232

License: 16087

Credentials and/or board

certification: No

Accepting New Members: Yes

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

174

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

Hours: M-F 8AM-5PM, SA

8AM-1PM

PTA: No

Other Language: Korean

Cultural Competency: NR

Members should call the

provider’s office to discuss

their accessibility needs.

UPDATE: NEW Provider Added.

Effective_Date: 01-MAR-20

90029

Lee, Soo LAc

1233 N Vermont Ave Ste 4

Los Angeles, CA 90029

(323) 661-0900

License: AC4700

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W,F 10AM-6PM, SA

10AM-3PM

PTA: No

Other Language: Spanish,

Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

90035

Das, Tara LAc

1155 S Beverly Dr

Los Angeles, CA 90035

(323) 538-0024

www.robertyoungsacupunctu

re.com

License: AC18304

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Whaite, Sommer DC

822 S Robertson Blvd Ste 300

Los Angeles, CA 90035

(323) 989-3551

www.drwhaitedc.com

License: DC32539

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

90036

Cheung, John LAc

5486 Wilshire Blvd

Los Angeles, CA 90036

(323) 954-8800

generateshen.com

License: 14318

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TU 8AM-4:30PM, W

2PM-7PM, TH 10AM-10:30PM, F

10AM-4PM, SA

11:30AM-3:30PM

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

175

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

PTA: No

Cultural Competency: NR

Accessibility: P, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Jolly, Cara LAc

5486 Wilshire Blvd

Los Angeles, CA 90036

(323) 954-8800

License: 15026

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 8AM-8PM

PTA: No

Cultural Competency: NR

Accessibility: R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Zarrabi, Cathrine DC

5757 Wilshire Blvd Ste Pr4

Los Angeles, CA 90036

(323) 930-0240

www.zarrabichiro.com

License: DC23415

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W 9AM-7PM, TU,TH

3PM-7PM, F 9AM-1PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: P, EB, R, 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.

90037

Lee, Sanghyun LAc

3809 1/2 Flower Dr

Los Angeles, CA 90037

(323) 375-0950

www.insightchoices.com

License: AC16795

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: SU 4PM-9PM, M

8AM-11PM

PTA: No

Other Language: Chinese,

Korean

Cultural Competency: NR

Accessibility: P, R; 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.

90038

Antoun, Cindy LAc

5600 Santa Monica Blvd Ste

304

Los Angeles, CA 90038

(323) 848-4580

License: AC15991

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TU 9AM-6PM

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

176

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

PTA: No

Other Language: Arabic

Cultural Competency: NR

Accessibility: P, EB, R, 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.

90039

Wright, Don DC

3171 Los Feliz Blvd Ste 217

Los Angeles, CA 90039

(818) 281-6990

License: DC29387

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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.

90041

Campins, Monica LAc

1551 Colorado Blvd Ste 206

Los Angeles, CA 90041

(323) 257-1901

www.acupuncturebymeridian

.com

License: AC4679

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TU,TH 9AM-5PM, SA

9AM-2PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: P, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Kim, Hye LAc

2501 Colorado Blvd Ste E

Los Angeles, CA 90041

(310) 292-3754

www.acupuncturemore.com

License: AC16790

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TU,TH 10AM-7PM, SA

10AM-5PM

PTA: No

Other Language: Japanese,

Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Santoro, Michelle DC

2501 Colorado Blvd Ste E

Los Angeles, CA 90041

(323) 687-3222

www.optimumhealthchiro.org

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

177

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

License: DC28508

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 9AM-7PM

PTA: No

Other Language: Spanish,

Hebrew

Cultural Competency: NR

Accessibility: P, EB, R, 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.

90044

Jung, Inho LAc

6104 S Vermont Ave

Los Angeles, CA 90044

(213) 605-1133

www.jungacupuncturegroup.

com

License: AC16791

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W 9:30AM-6PM, SA

9:30AM-3PM

PTA: No

Other Language: Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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.

90045

Cho, Eun LAc

8727 La Tijera Blvd

Los Angeles, CA 90045

(213) 389-3003

www.okbalance.com

License: AC12268

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TU,TH 10AM-6PM

PTA: No

Other Language: Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Nikroo, Alireza DC

8610 S Sepulveda Blvd Ste 204

Los Angeles, CA 90045

(310) 641-0222

License: DC33033

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W-F 8AM-5PM

PTA: No

Other Language: Spanish,

Persian

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

178

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

Park, Jae LAc

8727 La Tijera Blvd

Los Angeles, CA 90045

(213) 389-3003

License: AC11917

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TU,TH 10AM-6PM

PTA: No

Other Language: Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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.

90048

Khoubian, Anjel LAc

8300 W 3rd St

Los Angeles, CA 90048

(323) 653-3344

painreliefcenterla.com

License: AC18513

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: SU 9AM-1PM, M-F

9AM-6PM, SA 9AM-2PM

PTA: No

Other Language: Persian

Cultural Competency: NR

Members should call the

provider’s office to discuss

their accessibility needs.

UPDATE: NEW Provider Added.

Effective_Date: 01-MAR-20

Kravchenko, Mayya DC

6221 Wilshire Blvd Ste 604

Los Angeles, CA 90048

(323) 933-2444

License: DC27793

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 9AM-6PM, SA

9AM-2PM

PTA: No

Other Language: Spanish,

Russian

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Marinaro, Thomas DC

8300 W 3rd St

Los Angeles, CA 90048

(323) 653-3344

painreliefcenterla.com

License: DC18522

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W 9AM-8PM, TU,TH,F

9AM-7PM, SA 9AM-4PM

PTA: No

Other Language: Italian

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

90049

Yoser, Adam DC

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

179

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206

LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

13050 San Vicente Blvd Ste

Los Angeles, CA 90049

(310) 260-7611

www.brentwoodsportschiropr

actic.com

License: DC20047

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 9AM-7PM, SA

9AM-2PM

PTA: No

Other Language: French

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

90057

Armani, Robert DC

2010 Wilshire Blvd Ste 506

Los Angeles, CA 90057

(213) 738-1051

www.ArmaniChiropractic.com

License: DC24963

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 8:30AM-6:30PM, SA

9AM-2PM

PTA: No

Other Language: Hebrew

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Nourian, Kambiz DC

2520 W 8th St Ste 106

Los Angeles, CA 90057

(213) 389-2526

License: DC21764

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 9AM-5PM

PTA: No

Other Language: Persian

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Rhee, Sophia LAc

1930 Wilshire Blvd Ste 206

Los Angeles, CA 90057

(213) 483-1223

www.sophiaacuclinic.com

License: AC12353

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W,F 9AM-6PM, SA

9AM-2PM

PTA: No

Other Language: Spanish,

Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

180

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

Effective_Date: 01-MAR-20

90063

Bao, Tien DC

3800 E Cesar E Chavez Ave

Los Angeles, CA 90063

(323) 264-6296

License: DC27009

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 7AM-5PM

PTA: No

Other Language: Vietnamese

Cultural Competency: NR

Accessibility: P, EB, R, 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.

90064

Garcia, Jennifer LAc

10801 National Blvd Ste 254

Los Angeles, CA 90064

(323) 835-7404

www.jennygarciaacupunctur

e.com

License: AC17088

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W 9AM-9PM, F

8AM-12PM

PTA: No

Other Language: Spanish,

Portuguese

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Kim, Hye LAc

11340 W Olympic Blvd Ste 268

Los Angeles, CA 90064

(310) 292-3754

www.hyewellness.com

License: AC16790

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W,F 10AM-6PM

PTA: No

Other Language: Japanese,

Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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.

90066

Angelone, Elisa LAc

12114 Venice Blvd

Los Angeles, CA 90066

(415) 601-9605

www.pinboxacupuncture.co

m

License: 13438

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W,TH 3PM-8PM

PTA: No

Cultural Competency: NR

Members should call the

provider’s office to discuss

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

181

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120

LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

their accessibility needs.

UPDATE: NEW Provider Added.

Effective_Date: 01-MAR-20

Christie, Connie LAc

12030 W Washington Blvd Ste

Los Angeles, CA 90066

(310) 390-7500

www.acupuncture-rolfing.co

m

License: AC12746

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TU 9AM-2PM, W

10AM-7PM, TH,F 10AM-5PM, SA

10AM-1PM

PTA: No

Other Language: Spanish,

German

Cultural Competency: NR

Accessibility: R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Das, Tara LAc

12030 W Washington Blvd

Los Angeles, CA 90066

(310) 390-7500

www.acupuncturemarvista.co

m

License: AC18304

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,SA,SU 9AM-2PM, TU

9AM-7PM, W,F 10AM-7PM, TH

9AM-8PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Fox-rabinovich, Lola LAc

3030 Sawtelle Blvd

Los Angeles, CA 90066

(310) 390-9018

www.healthatlastusa.com/wla

License: 18302

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-W,F 9AM-7PM, SA

9AM-1PM

PTA: No

Other Language: Russian

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Gutierrez, Andrew DC

12568 W Washington Blvd Ste

202

Los Angeles, CA 90066

(310) 482-3252

www.brigitterozenbergdc.co

m

License: DC31575

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-TH 8AM-8PM, F

9AM-5PM, SA 9AM-2PM

PTA: No

Cultural Competency: NR

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

182

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

Accessibility: P, EB, R, 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.

Lee, Jiny LAc

3030 Sawtelle Blvd

Los Angeles, CA 90066

(310) 453-8393

healthatlastusa.com

License: 15052

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TU,W 9AM-7PM, SA

9AM-1PM

PTA: No

Other Language: Korean

Cultural Competency: NR

Accessibility: P, EB, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Orselli, Rachel LAc

3807 Grand View Blvd

Los Angeles, CA 90066

(323) 872-2339

www.acupunctureinla.org

License: AC9366

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M 9AM-5PM, TU,TH

8AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Ramirez, Jessica DC

11321 W Washington Blvd

Los Angeles, CA 90066

(310) 398-0636

pacificwesthealthcenter.com

License: DC23572

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

90069

Khoubian, Anjel LAc

8730 W Sunset Blvd

Los Angeles, CA 90069

(323) 302-8221

License: AC18513

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Other Language: Persian

Cultural Competency: NR

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

183

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

Members should call the

provider’s office to discuss

their accessibility needs.

UPDATE: NEW Provider Added.

Effective_Date: 01-MAR-20

LYNWOOD

90262

Higashi, Randy DC

3621 Martin Luther King Jr Blvd

Ste 14

Lynwood, CA 90262

(323) 546-3500

www.rshigashichiropractic.co

m

License: DC26404

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: P, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

MONROVIA

91016

Chung Morita, Jonie DC

120 W Olive Ave

Monrovia, CA 91016

(626) 235-8818

https://betterhealthchiro.my-fr

ee.website/

License: DC28353

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TU,TH 9:30AM-6:30PM, F

2:30AM-6:30PM, SA 9AM-12PM

PTA: No

Other Language: Chinese

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Lai, Wes LAc

686 W Foothill Blvd

Monrovia, CA 91016

(626) 281-1588

License: 14105

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 10AM-5PM

PTA: No

Other Language: Chinese

Cultural Competency: NR

Accessibility: P, EB, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

MONTEREY PARK

91754

Fan, Ting Wen LAc

223 N Garfield Ave Ste 301

Monterey Park, CA 91754

(310) 359-3911

License: 09793

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TU 2PM-5PM, F 3PM-5PM

PTA: No

Other Language: Chinese

Cultural Competency: NR

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

184

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Lee, Yang-chau LAc

925 S Atlantic Blvd Ste 106

Monterey Park, CA 91754

(626) 679-3636

www.AcucareAcupuncture.c

om

License: AC8362

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TU,SA 9AM-12PM

PTA: No

Other Language: Chinese

Cultural Competency: NR

Accessibility: P, EB, R, 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.

MONTROSE

91020

Haas, Bryan DC

2255 Honolulu Ave Ste 2a

Montrose, CA 91020

(818) 957-1217

www.advancedhealthsolution

sla.com

License: DC24395

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M 8AM-6PM, TU-TH

9:30AM-6PM, SA 8AM-11AM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Ho, Diep LAc

4142 Ocean View Blvd

Montrose, CA 91020

(626) 576-4644

License: AC4732

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W 9AM-7PM, F

9AM-1PM

PTA: No

Other Language: Vietnamese

Cultural Competency: NR

Accessibility: P, EB, R, 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.

NEWHALL

91321

Getting, Michael DC

25078 Peachland Ave Ste E

Newhall, CA 91321

(805) 206-1551

License: DC31713

Credentials and/or board

certification: No

Accepting New Members: Yes

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

185

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

Hours: M,W,F 8AM-5PM, TU,TH

10AM-6PM, SA 9AM-1PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

NORTH HOLLYWOOD

91607

Lee, Hyo LAc

5953 Laurel Canyon Blvd Ste A

North Hollywood, CA 91607

(408) 529-4947

License: AC18006

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TU,TH 9AM-5PM, SA

9AM-2PM

PTA: No

Other Language: Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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.

NORTHRIDGE

91324

Ryu, Hu Ki LAc

9535 Reseda Blvd Ste 101

Northridge, CA 91324

(818) 700-0901

License: AC10645

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M 10AM-6PM, TU,TH,F

10AM-5PM, W 10AM-12PM, SA

11AM-1PM

PTA: No

Other Language: Chinese,

Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Shaw, Ronald DC

19350 Business Center Dr Ste

103

Northridge, CA 91324

(818) 993-3668

License: DC31188

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W,F 9AM-7PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

PALMDALE

93550

Panoussi, Frank DC

38344 30th St E

Palmdale, CA 93550

(661) 273-1101

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

186

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

www.chiropractorinpalmdale.

com

License: DC23943

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 9AM-6PM

PTA: No

Other Language: Persian

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Yeganeh Hajahmadi,

Mahmoud LAc

1850 E Palmdale Blvd

Palmdale, CA 93550

(661) 224-1114

License: AC15561

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 9AM-5PM

PTA: No

Other Language: Persian

Cultural Competency: NR

Accessibility: P, EB, R, 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.

PANORAMA CITY

91402

Dasilva, Antonio LAc

13550 Roscoe Blvd Ste 6

Panorama City, CA 91402

(818) 894-4437

advantagehealth.us

License: 12089

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 9AM-5PM

PTA: No

Other Language: Spanish,

Portuguese, American Sign

Language

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Sako, Manhal DC

8780 Van Nuys Blvd Ste B

Panorama City, CA 91402

(818) 894-3111

License: DC23585

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 8AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

PARAMOUNT

90723

Durrani, Asif DC

16444 Paramount Blvd Ste 103

Paramount, CA 90723

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

187

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

(562) 531-2290

www.drasifsdurranidc.com

License: DC24711

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 1PM-2PM

PTA: No

Other Language: Urdu, Hindi

Cultural Competency: NR

Accessibility: P, R, 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.

Durrani, Asif DC

16209 Paramount Blvd Ste 205

Paramount, CA 90723

(562) 531-2290

License: DC24711

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 9AM-5PM

PTA: No

Other Language: Urdu, Hindi

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Han, Dong Gwon LAc

16444 Paramount Blvd Ste 208

Paramount, CA 90723

(310) 933-7052

License: 12935

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 10AM-7PM, SA

10AM-5PM

PTA: No

Other Language: Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

PASADENA

91101

Laveck, Londa LAc

133 S Hudson Ave Ste 4

Pasadena, CA 91101

(562) 760-2338

www.healthybodyandsoul.info

License: AC17034

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Markle, Susan DC

709 E Colorado Blvd Ste 140

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

188

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

Pasadena, CA 91101

(626) 310-7700

License: DC16609

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-TH 9AM-7PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Ren, Jian-ching LAc

80 N Lake Ave Ste 103

Pasadena, CA 91101

(626) 466-5364

License: AC15363

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Other Language: Chinese

Cultural Competency: NR

Members should call the

provider’s office to discuss

their accessibility needs.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

91104

Laveck, Londa LAc

1452 E Washington Blvd

Pasadena, CA 91104

(562) 760-2338

www.healthybodyandsoul.info

License: AC17034

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 10AM-7PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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.

91106

Fong, Ryan LAc

1060 E Green St Ste 106

Pasadena, CA 91106

(323) 423-3061

fongacu.com

License: AC13791

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 9AM-6PM, SA

9AM-12:30PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Lee, Jason LAc

935 E Green St

Pasadena, CA 91106

(626) 796-4141

www.moralesholistic.com

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

189

Page 195: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

License: AC18030

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W,F 10AM-6PM, TU,TH

9AM-7PM, SA 9AM-2PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Lee, Jason DC

935 E Green St

Pasadena, CA 91106

(626) 796-4141

www.moralesholistic.com

License: DC33980

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W,F 10AM-6PM, TU,TH

9AM-7PM, SA 9AM-2PM

PTA: No

Other Language: Mandarin

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Morales, Carolina DC

935 E Green St

Pasadena, CA 91106

(626) 796-4141

www.moralesholistic.com

License: DC31297

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W,F 10AM-6PM, TU,TH

9AM-7PM, SA 9AM-2PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

91107

Lu, Mei LAc

213 N Sierra Madre Blvd

Pasadena, CA 91107

(626) 584-9788

License: AC5891

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W-F 10AM-7PM, SA

10AM-4PM

PTA: No

Other Language: Chinese

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Miller, Pamela LAc

2750 E Washington Blvd Ste

140

Pasadena, CA 91107

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

190

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

(626) 755-9864

www.healmedicalarts.com

License: 03644

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W,F 7AM-7PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Smaliy, Yuliya LAc

2595 E Washington Blvd Ste

103

Pasadena, CA 91107

(626) 399-2435

License: AC14343

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TU,TH,F 3PM-6PM, SA

8:30AM-1PM

PTA: No

Other Language: Russian,

Ukrainian

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Yaghjian, Ara DC

2595 E Washington Blvd Ste

103

Pasadena, CA 91107

(626) 798-8951

License: DC14289

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W,F 9AM-1PM, TU,TH

2PM-6PM, SA 10AM-12PM

PTA: No

Other Language: Arabic,

Classical Armenian

Cultural Competency: NR

Accessibility: P, EB, R, 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.

PLAYA VISTA

90094

Kwon, Yeung LAc

5450 Lincoln Blvd

Playa Vista, CA 90094

(800) 385-1130

www.elimacu.com

License: AC4960

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Other Language: Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

191

Page 197: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

POMONA

91767

Hou, Poyuan LAc

175 W La Verne Ave Ste A

Pomona, CA 91767

(909) 741-7690

www.aeonacupuncture.com

License: AC17667

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Other Language: Chinese

Cultural Competency: NR

Accessibility: P, EB, R, 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.

91768

Butts, Myron LAc

131 W Willow St

Pomona, CA 91768

(909) 461-6313

License: AC12860

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Butts, Myron DC

131 W Willow St

Pomona, CA 91768

(909) 461-6313

License: DC30680

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Rodriguez, Oscar DC

675 N Park Ave

Pomona, CA 91768

(909) 620-0808

License: DC25613

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-TH 9AM-5PM, F

9AM-1PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: P, R, 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.

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

192

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

REDONDO BEACH

90278

Chanthakaew, Umawan LAc

2925 182nd St

Redondo Beach, CA 90278

(310) 283-0618

www.acubodyworks.com

License: AC17867

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: SU 10AM-3PM, M,TH,SA

10AM-8PM

PTA: No

Other Language: Thai

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Orend, Liesel LAc

2009 Artesia Blvd Ste B

Redondo Beach, CA 90278

(310) 372-8020

www.orendhealingarts.com

License: 17254

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TU-TH 8AM-7PM, F

8AM-12PM, SA 9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

RESEDA

91335

Antoun, Cindy LAc

19231 Victory Blvd Ste 150

Reseda, CA 91335

(818) 492-9383

License: AC15991

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M 10:30AM-6PM, TU,TH,F

9AM-6PM

PTA: No

Other Language: Arabic

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Brody, Bruce DC

19231 Victory Blvd Ste 352

Reseda, CA 91335

(818) 887-2225

brucebrodydc.com

License: DC20925

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SU 9AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: EB, R, 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;

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

193

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

demographic, phone and/or

panel status.

Chen, Quincy LAc;DOM

7620 Lindley Ave

Reseda, CA 91335

(818) 705-2633

www.ch-acupuncture.com

License: AC2859

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,TH 11AM-7PM, TU,F

10AM-7PM

PTA: No

Other Language: Chinese,

Mandarin

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Edery, Gabriel DC

7439 Reseda Blvd

Reseda, CA 91335

(818) 345-4924

www.drgabyedery.com

License: DC32583

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W 8:30AM-6PM, TU,F

8:30AM-12PM

PTA: No

Other Language: Hebrew

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Lu, Yong Jun LAc

19231 Victory Blvd Ste 450

Reseda, CA 91335

(818) 886-8883

northridgeacupuncture.com

License: AC12968

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M 9AM-5PM, TU-F

7AM-7PM, SA 7AM-2PM

PTA: No

Other Language: Chinese

Cultural Competency: NR

Accessibility: P, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Nourian, Kambiz DC

7012 Reseda Blvd Ste D

Reseda, CA 91335

(818) 776-1205

License: DC21764

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 9AM-5PM

PTA: No

Other Language: Persian

Cultural Competency: NR

Accessibility: P, EB, R, W;

Members should call the

provider’s office to discuss

their accessibility needs when

there is limited access or when

accessibility indicators are not

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

194

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

present.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Santoro, Michelle DC

19231 Victory Blvd Ste 255

Reseda, CA 91335

(818) 345-3900

License: DC28508

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 9AM-7PM

PTA: No

Other Language: Spanish,

Hebrew

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Tajyar, Amber LAc

19231 Victory Blvd Ste 255

Reseda, CA 91335

(818) 345-3900

License: AC4905

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M 9AM-1PM, TU

1PM-6PM

PTA: No

Other Language: Persian

Cultural Competency: NR

Accessibility: 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.

ROSEMEAD

91770

Chen, Quincy LAc;DOM

3235 San Gabriel Blvd

Rosemead, CA 91770

(626) 288-1233

www.ch-acupuncture.com

License: AC2859

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: W,SA 11AM-6PM

PTA: No

Other Language: Chinese,

Mandarin

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Jing, Ran LAc

7940 Garvey Ave Ste 205

Rosemead, CA 91770

(626) 703-4818

License: 14966

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-5PM

PTA: No

Other Language: Chinese

Cultural Competency: NR

Accessibility: P, W; Members

should call the provider’s

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

195

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

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-MAR-20

Pham, Tung LAc

8966 Garvey Ave Ste I

Rosemead, CA 91770

(626) 626-5567

License: AC15439

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: W,TH,SA,SU 9AM-5PM, M

9AM-1PM, F 2AM-5PM

PTA: No

Other Language: Spanish,

Vietnamese, Mandarin

Cultural Competency: NR

Accessibility: P, EB, R, 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.

ROWLAND HEIGHTS

91748

Fong, Richard LAc

1818 Sierra Leone Ave Ste A

Rowland Heights, CA 91748

(626) 854-3451

License: AC3297

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M 9AM-2PM, W,F

2PM-6PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Fong, Richard DC

1818 Sierra Leone Ave Ste A

Rowland Heights, CA 91748

(626) 854-3451

License: DC17488

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M 9AM-1PM, W,F

2PM-6PM

PTA: No

Other Language: Chinese

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Hung, Alex LAc;DOM

18369 Colima Rd

Rowland Heights, CA 91748

(909) 973-4819

License: AC15637

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W-SA 10AM-5PM

PTA: No

Other Language: Mandarin

Cultural Competency: NR

Accessibility: P, EB, R, W;

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

196

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

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.

Hung, Alex LAc;DOM

1788 Sierra Leone Ave Ste 102

Rowland Heights, CA 91748

(909) 973-4819

License: AC15637

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W-SA 10AM-6PM

PTA: No

Other Language: Mandarin

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Jeong, Hoi Jun LAc

1725 Nogales St Ste 105

Rowland Heights, CA 91748

(626) 602-6083

License: 14176

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 9AM-5PM, SA

9AM-2PM

PTA: No

Other Language: Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Tiu, Kai Fong LAc

18938 Labin Ct Ste A205-2

Rowland Heights, CA 91748

(626) 913-9868

License: 04495

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Other Language: Mandarin

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Wang, Ping-long DC

1722 Desire Ave Ste 205

Rowland Heights, CA 91748

(626) 581-3578

License: DC32042

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 9AM-6:30PM, SA

9AM-1PM

PTA: No

Other Language: Chinese

Cultural Competency: NR

Accessibility: P, EB, R, W;

Members should call the

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

197

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

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-MAR-20

SAN DIMAS

91773

Movsessian, Claude DC

1305 W Arrow Hwy Ste 106

San Dimas, CA 91773

(626) 331-3988

www.anatomyofhealth.com

License: DC23922

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Other Language: German,

Persian, Classical Armenian

Cultural Competency: NR

Accessibility: P, EB, R, 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.

SAN GABRIEL

91775

Yu, Yoshimi LAc

9116 E Fairview Ave

San Gabriel, CA 91775

(626) 215-1577

www.acuhealth2s.com

License: AC9171

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-12PM

PTA: No

Other Language: Chinese,

Japanese

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

91776

Yang, Alan LAc

919 E Las Tunas Dr

San Gabriel, CA 91776

(626) 675-6299

License: AC10978

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W,F 9AM-5PM

PTA: No

Other Language: Chinese,

Japanese

Cultural Competency: NR

Accessibility: P, R, 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.

Yao, Chien-kuo LAc

919 E Las Tunas Dr

San Gabriel, CA 91776

(626) 285-0588

License: AC2174

Credentials and/or board

certification: No

Accepting New Members: Yes

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

198

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

Hours: M-F 9AM-6PM, SA

9AM-5PM

PTA: No

Other Language: Chinese

Cultural Competency: NR

Accessibility: P, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

SAN MARINO

91108

Hsu, Richard LAc

2343 Huntington Dr

San Marino, CA 91108

(626) 793-5700

www.alternativemedicalclinic.

com

License: AC6530

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: SU 9AM-12PM, M,F,SA

9AM-7PM, W 9AM-1PM

PTA: No

Other Language: Spanish,

Chinese

Cultural Competency: NR

Accessibility: P, EB, 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.

SAN PEDRO

90731

Hoinsky, Michelle DC

660 W 7th St

San Pedro, CA 90731

(310) 832-4476

License: DC34090

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,F 10AM-6PM, TU,TH

9:30AM-6PM, W 9:30AM-3PM,

SA 9:30AM-1PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

90732

Baez, Maria LAc

1428 W 7th St Ste 4b

San Pedro, CA 90732

(310) 547-2197

sanpedrohealingarts.com

License: AC10137

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TU-TH 9AM-6PM, F

9AM-4PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

SANTA CLARITA

91321

Herta, Kelly DC

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

199

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

23043 Lyons Ave

Santa Clarita, CA 91321

(661) 288-0022

www.unruhspinecenter.com

License: DC30274

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TH 9AM-11:30AM, SA

9AM-12PM

PTA: No

Cultural Competency: NR

Accessibility: EB, 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.

Kim, A Young LAc

23043 Lyons Ave

Santa Clarita, CA 91321

(661) 288-0022

www.unruhspinecenter.com

License: AC10599

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TU 2PM-6PM, TH

1:30AM-5PM, SA 8:30AM-11AM

PTA: No

Other Language: Korean

Cultural Competency: NR

Members should call the

provider’s office to discuss

their accessibility needs.

UPDATE: NEW Provider Added.

Effective_Date: 01-MAR-20

SANTA MONICA

90401

Hogan, James DC

201 Santa Monica Blvd

Santa Monica, CA 90401

(310) 699-9299

www.activebodychirocare.co

m

License: DC30436

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

90404

Fox-rabinovich, Lola LAc

2428 Santa Monica Blvd Ste

308

Santa Monica, CA 90404

(310) 390-9018

www.healthatlastusa.com/wla

License: 18302

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-W,F 9AM-7PM, SA

9AM-1PM

PTA: No

Other Language: Russian

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

200

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105

LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

Hsu, Richard LAc

2222 Santa Monica Blvd Ste

Santa Monica, CA 90404

(626) 793-5700

www.alternativemedicalclinic.

com

License: AC6530

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M 9AM-7PM

PTA: No

Other Language: Spanish,

Chinese

Cultural Competency: NR

Accessibility: P, EB, 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.

Seok, Puchun LAc

1228 15th St Ste E

Santa Monica, CA 90404

(310) 393-3868

License: AC11582

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 9AM-5PM, SA

9AM-1PM

PTA: No

Other Language: Spanish,

Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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.

SAUGUS

91350

Wright-dohopolski, Brandi LAc

26893 Bouquet Canyon Rd Ste

F

Saugus, CA 91350

(661) 609-5998

www.soulstrongwellness.com

License: 18096

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W 9AM-8PM, TU,TH

9AM-6PM, F 9AM-5PM, SA

12:30PM-3:30PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

SHERMAN OAKS

91403

Byun, Hayeon LAc

4849 Van Nuys Blvd Ste 202

Sherman Oaks, CA 91403

(818) 784-5300

License: 12075

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Other Language: Korean

Cultural Competency: NR

Accessibility: P, EB, R, W;

Members should call the

provider’s office to discuss

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

201

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

their accessibility needs when

there is limited access or when

accessibility indicators are not

present.

UPDATE: NEW Provider Added.

Effective_Date: 01-MAR-20

Chuang, Gina Hua Qin LAc

4849 Van Nuys Blvd Ste 206

Sherman Oaks, CA 91403

(818) 386-0629

License: AC7175

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W,F 8AM-2PM, TU,TH

8AM-6PM, SA 8AM-3PM

PTA: No

Other Language: Chinese,

Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Lee, Hyo LAc

4940 Van Nuys Blvd Ste 304

Sherman Oaks, CA 91403

(747) 998-5330

zeroneclinic.com

License: AC18006

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 9AM-5PM, SA

9AM-2PM

PTA: No

Other Language: Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

91423

Hsu, Richard LAc;DOM

13425 Ventura Blvd Ste 100

Sherman Oaks, CA 91423

(818) 990-9345

alternativemedicalclinic.com

License: AC6530

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TU,TH 3PM-7PM

PTA: No

Other Language: Spanish,

Chinese

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Logan, Zena LAc

14242 Ventura Blvd Ste 200

Sherman Oaks, CA 91423

(323) 213-9220

thelivingpoint.com

License: AC17122

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, W;

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

202

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

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.

Plotkin, Natalia LAc;DOM

14460 Ventura Blvd

Sherman Oaks, CA 91423

(818) 355-8088

www.nataliaplotkin.com

License: AC16211

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Other Language: German,

Russian

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

SIERRA MADRE

91024

Talevich, John DC

31 S Baldwin Ave

Sierra Madre, CA 91024

(626) 224-3476

www.johnmtalevich.com

License: DC12836

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W,TH 10AM-5PM,

TU,SA 9AM-3PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

SOUTH EL MONTE

91733

Chang, Chung Young LAc

10414 Vacco St

South El Monte, CA 91733

(626) 636-8706

www.TzuchiMedicalGroup.co

m

License: AC8360

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TU-SA 9AM-6PM

PTA: No

Other Language: Chinese

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Chen, Jeng-shiang LAc

10414 Vacco St

South El Monte, CA 91733

(626) 636-8706

License: AC10577

Credentials and/or board

certification: No

Accepting New Members: Yes

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

203

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

Hours: TU,TH,SA 9AM-6PM

PTA: No

Other Language: Mandarin

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Lai, Yi-hsien LAc

10414 Vacco St

South El Monte, CA 91733

(626) 636-8706

License: AC8087

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TU-SA 9AM-6PM

PTA: No

Other Language: Chinese

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Lin, Chi-yi LAc

10414 Vacco St

South El Monte, CA 91733

(626) 636-8706

License: AC8867

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TU-SA 9AM-5PM

PTA: No

Other Language: Mandarin

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Lin, Steven LAc

10414 Vacco St

South El Monte, CA 91733

(626) 636-8706

License: AC14534

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TU-SA 9AM-5PM

PTA: No

Other Language: Chinese,

Mandarin

Cultural Competency: NR

Members should call the

provider’s office to discuss

their accessibility needs.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Wang, Chiao-nien LAc

10414 Vacco St

South El Monte, CA 91733

(626) 636-8706

License: AC4403

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TU,TH-SA 9AM-6PM

PTA: No

Other Language: Chinese,

Mandarin

Cultural Competency: NR

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

204

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

Members should call the

provider’s office to discuss

their accessibility needs.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

SOUTH GATE

90280

Blakely, David DC

4476 Tweedy Blvd

South Gate, CA 90280

(323) 563-9499

License: DC13938

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TU,F 8AM-6PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: EB, 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.

SOUTH PASADENA

91030

Fong, Richard LAc

1949 Huntington Dr

South Pasadena, CA 91030

(626) 799-8855

License: AC3297

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TU,TH 12:30PM-6PM, SA

9:30AM-1:30PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Fong, Richard DC

1949 Huntington Dr

South Pasadena, CA 91030

(626) 854-3451

License: DC17488

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M 9AM-1PM, W,F

2PM-6PM

PTA: No

Other Language: Chinese

Cultural Competency: NR

Accessibility: P, EB, R, 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.

St Juste, Carlo LAc

1017 Fremont Ave Ste A

South Pasadena, CA 91030

(626) 441-4888

http://www.csjacupuncture.c

om

License: AC14551

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TU 10AM-4PM, TH

10AM-6PM

PTA: No

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

205

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

Cultural Competency: NR

Accessibility: P, EB, R, 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.

STUDIO CITY

91604

Cheung, John LAc

11988 Ventura Blvd Ste 6

Studio City, CA 91604

(818) 940-1168

License: 14318

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

SYLMAR

91342

Yang, Alan LAc

13519 Hubbard St

Sylmar, CA 91342

(818) 833-5977

License: AC10978

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-6PM

PTA: No

Other Language: Chinese,

Japanese

Cultural Competency: NR

Members should call the

provider’s office to discuss

their accessibility needs.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

TARZANA

91356

Goel, Nadia DC

18345 Ventura Blvd Ste 104

Tarzana, CA 91356

(818) 343-8800

www.drnadiagoel.com

License: DC26550

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,TU,TH-SA 9AM-5PM

PTA: No

Other Language: Persian

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Goleh, Shadi DC

19100 Ventura Blvd Ste 10

Tarzana, CA 91356

(818) 343-0303

www.doctorshadi.com

License: DC29124

Credentials and/or board

certification: No

Accepting New Members: Yes

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

206

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

Hours: M,W 9AM-5PM, F accessibility indicators are not License: AC16258

9AM-8PM present. Credentials and/or board

PTA: No UPDATE: NEW Provider Added. certification: No

Other Language: Spanish, Effective_Date: 01-MAR-20 Accepting New Members: Yes

Persian Hours: TH 6AM-6PM

Cultural Competency: NR PTA: No

Accessibility: P, EB, R, W; Lee, Judy DC Other Language: Spanish

Members should call the 5567 Reseda Blvd Ste 101 Cultural Competency: NR

provider’s office to discuss Tarzana, CA 91356 Accessibility: P, EB, R, W;

their accessibility needs when (213) 387-4710 Members should call the

there is limited access or when License: DC15287 provider’s office to discuss

accessibility indicators are not Credentials and/or board their accessibility needs when

present. certification: No there is limited access or when

UPDATE: NEW Provider Added. Accepting New Members: Yes accessibility indicators are not

Effective_Date: 01-MAR-20 Hours: Contact facility for present.

hours of operation UPDATE: There was a change

PTA: No in the provider record;

Lee, Judy LAc Cultural Competency: NR demographic, phone and/or

5567 Reseda Blvd Ste 101 Accessibility: P, EB, R, W; panel status.

Tarzana, CA 91356 Members should call the

(213) 387-4710 provider’s office to discuss

License: AC2914 their accessibility needs when Logan, Zena LAc

Credentials and/or board there is limited access or when 18663 Ventura Blvd Ste 202

certification: No accessibility indicators are not Tarzana, CA 91356

Accepting New Members: Yes present. (323) 213-9220

Hours: Contact facility for UPDATE: NEW Provider Added. thelivingpoint.com

hours of operation Effective_Date: 01-MAR-20 License: AC17122

PTA: No Credentials and/or board

Cultural Competency: NR certification: No

Accessibility: P, EB, R, W; Logan, Conor LAc Accepting New Members: Yes

Members should call the 18663 Ventura Blvd Ste 202 Hours: TH 9AM-3PM

provider’s office to discuss Tarzana, CA 91356 PTA: No

their accessibility needs when (323) 213-9220 Cultural Competency: NR

there is limited access or when thelivingpoint.com Accessibility: P, EB, R, W;

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

207

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

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.

TEMPLE CITY

91780

Chen, Yuying LAc

9722 Las Tunas Dr

Temple City, CA 91780

(626) 672-0303

www.amplusacupuncture.co

m

License: AC14906

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TU,TH 10AM-6:30PM

PTA: No

Other Language: Spanish,

Chinese, Mandarin,

Indonesian

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Fan, Ting Wen LAc

5644 Rosemead Blvd

Temple City, CA 91780

(310) 359-3911

License: 09793

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M 9AM-5PM, TU

9AM-1PM, W 9AM-2PM, TH-SA

10AM-6PM

PTA: No

Other Language: Chinese

Cultural Competency: NR

Accessibility: EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Hong, Zhen-li LAc

10405 Lower Azusa Rd

Temple City, CA 91780

(626) 444-8588

License: AC5692

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-W,F 9AM-7PM, TH

9AM-1PM, SA 8:30AM-1PM

PTA: No

Other Language: Mandarin

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Huo, Wayne LAc

10405 Lower Azusa Rd

Temple City, CA 91780

(626) 444-8588

License: AC16081

Credentials and/or board

certification: No

Accepting New Members: Yes

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

208

Page 214: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

Hours: M-W,F 9AM-7PM, TH

9AM-1PM, SA 8:30AM-1PM

PTA: No

Other Language: Mandarin

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Lin, Charles DC

10405 Lower Azusa Rd

Temple City, CA 91780

(626) 444-8588

License: DC26220

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-W,F 9AM-7PM, TH

9AM-1PM, SA 8:30AM-1PM

PTA: No

Other Language: Mandarin

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Lu, Yang LAc

10405 Lower Azusa Rd

Temple City, CA 91780

(626) 444-8588

License: AC18057

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-W,F 9AM-7PM, TH

9AM-1PM, SA 8:30AM-2PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Wang, Yang LAc

9670 Las Tunas Dr

Temple City, CA 91780

(626) 716-5778

License: 18654

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,F 10AM-6PM, W

10AM-2PM

PTA: No

Other Language: Mandarin

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

TORRANCE

90501

Wong, Thomas DC

2204 Torrance Blvd Ste 101b

Torrance, CA 90501

(310) 773-9868

License: DC30431

Credentials and/or board

certification: No

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

209

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

Accepting New Members: Yes

Hours: TU,TH 9AM-7PM, W

1:30PM-7PM, SA 9AM-12PM

PTA: No

Other Language: Mandarin

Cultural Competency: NR

Accessibility: P, EB, R, 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.

90504

Lee, Young LAc

17223 Crenshaw Blvd

Torrance, CA 90504

(310) 532-3070

License: 07757

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W,F 9AM-6PM

PTA: No

Other Language: Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Zwickel, Joseph DC

2326 Redondo Beach Blvd

Torrance, CA 90504

(310) 523-4494

License: DC22907

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W,F 9AM-6PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: P, EB, 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.

VALENCIA

91355

Griffin, Daniel DC

28039 Smyth Dr Ste 102

Valencia, CA 91355

(661) 505-6303

griffinfamilywellness.com

License: DC31901

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Herta, Kelly DC

23838 Valencia Blvd Ste 105

Valencia, CA 91355

(661) 288-0022

www.unruhspinecenter.com

License: DC30274

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

210

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W 9AM-5:45PM, F

8:30AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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.

VALLEY VILLAGE

91607

Kravchenko, Mayya DC

12626 Riverside Dr Ste 510

Valley Village, CA 91607

(818) 623-9633

License: DC27793

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W,F 9AM-6PM

PTA: No

Other Language: Spanish,

Russian

Cultural Competency: NR

Accessibility: P, EB, R, 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.

VAN NUYS

91401

Armani, Robert DC

6525 Van Nuys Blvd

Van Nuys, CA 91401

(818) 988-2123

www.armanichiropractic.com

License: DC24963

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 9AM-7PM

PTA: No

Other Language: Hebrew

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Tabibian, Roya DC

13760 Victory Blvd

Van Nuys, CA 91401

(310) 202-2100

License: DC25185

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 10AM-6PM

PTA: No

Other Language: Persian

Cultural Competency: NR

Accessibility: P, EB, R, 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.

91405

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

211

Page 217: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

Canabal, Manuel LAc

6640 Van Nuys Blvd Ste 201

Van Nuys, CA 91405

(818) 904-6700

License: AC12605

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Lin, Hope LAc

15216 Vanowen St Ste 2c

Van Nuys, CA 91405

(818) 439-7769

License: AC7493

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M 9AM-6PM, W

9AM-12PM, TH 9:30AM-3PM,

SA 9:30AM-12PM

PTA: No

Other Language: Mandarin

Cultural Competency: NR

Accessibility: P, EB, 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.

Reinherz, Ira DC

7621 Van Nuys Blvd

Van Nuys, CA 91405

(818) 855-1627

License: DC18605

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 8:30AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

91406

Gutierrez, Andrew DC

15710 1/2 Vanowen St

Van Nuys, CA 91406

(818) 901-1505

www.brigitterozenbergdc.co

m

License: DC31575

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-TH 10AM-7PM, SA

10AM-2PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

212

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

Kim, Chul Un LAc

7120 Hayvenhurst Ave Ste

206a

Van Nuys, CA 91406

(213) 718-2115

License: 12738

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SU 8AM-8PM

PTA: No

Other Language: Japanese,

Korean

Cultural Competency: NR

Accessibility: P, EB, R; 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-MAR-20

VENICE

90291

Garcia, Rachael LAc

604 Rose Ave

Venice, CA 90291

(310) 664-7749

venicefamilyclinic.org

License: AC18039

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Orselli, Rachel LAc

1106 Garfield Ave

Venice, CA 90291

(323) 872-2339

www.acupunctureinla.org

License: AC9366

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,TU,TH 9AM-5PM, F

2AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Papenhagen, Ted DC

604 Rose Ave

Venice, CA 90291

(310) 664-7819

venicefamilyclinic.org

License: DC30480

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W-F 8AM-5PM, TU

8AM-9PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

WALNUT

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

213

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

91789

Chang, Guang Di LAc

20272 Carrey Rd

Walnut, CA 91789

(626) 765-5678

License: 12747

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,TU,TH,F 11AM-7PM

PTA: No

Other Language: Mandarin

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Cohen, Jordan DC

100 Pierre Rd Ste A

Walnut, CA 91789

(909) 773-2510

www.TheInjuryChiro.com

License: DC33294

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Other Language: Spanish,

Mandarin

Cultural Competency: NR

Accessibility: P, EB, R, 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.

WEST COVINA

91790

Chan, Cheuk Man LAc

1433 W Merced Ave Ste 309

West Covina, CA 91790

(626) 513-8029

License: 18396

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 9AM-6PM, SA

9AM-4PM

PTA: No

Other Language: Mandarin

Cultural Competency: NR

Accessibility: P, EB, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Rodriguez, Oscar DC

741 S Orange Ave Ste 175

West Covina, CA 91790

(626) 854-1144

License: DC25613

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TU-TH 9AM-5PM, F

9AM-1PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: P, R, 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

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

214

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

panel status.

Yang, Alan LAc

1415 W Garvey Ave N Ste 110

West Covina, CA 91790

(626) 675-6299

License: AC10978

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-SA 9AM-6PM

PTA: No

Other Language: Chinese,

Japanese

Cultural Competency: NR

Accessibility: P, EB, R, 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.

91791

Caropino, Blake DC

2649 E Charlinda St

West Covina, CA 91791

(626) 675-2406

License: DC33880

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Cultural Competency: NR

Members should call the

provider’s office to discuss

their accessibility needs.

UPDATE: NEW Provider Added.

Effective_Date: 01-MAR-20

WEST HILLS

91304

Chen, Ta Fang LAc

23723 Roscoe Blvd

West Hills, CA 91304

(818) 710-1566

License: AC2193

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,F 11AM-5PM, TU,TH,SA

10AM-12PM, W 10AM-4PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Lin, Hope LAc

22110 Roscoe Blvd Ste 304

West Hills, CA 91304

(818) 439-7769

License: AC7493

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TU 9AM-12:30PM, W

1:30PM-5:30PM, F 9AM-5PM

PTA: No

Other Language: Mandarin

Cultural Competency: NR

Accessibility: P, EB, R, 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.

WEST HOLLYWOOD

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

215

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

90046

Lee, Sanghyun LAc

8265 W Sunset Blvd Ste 207

West Hollywood, CA 90046

(323) 375-0950

www.insightchoices.com

License: AC16795

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TU 7AM-11PM, SA

9AM-7PM

PTA: No

Other Language: Chinese,

Korean

Cultural Competency: NR

Accessibility: P, 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.

90069

Hogan, James DC

8590 W Sunset Blvd

West Hollywood, CA 90069

(310) 699-9299

www.activebodychirocare.co

m

License: DC30436

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TU,TH,SA 9AM-6PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

WEST LOS ANGELES

90025

Li, Jack DC

12340 Santa Monica Blvd Ste

129

West Los Angeles, CA 90025

(310) 207-1007

www.drjacklidc.com

License: DC31142

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W 10AM-6PM, TU

10AM-7PM, TH 10:30AM-7PM,

SA 9AM-3PM

PTA: No

Other Language: Spanish,

Chinese, Vietnamese

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

WHITTIER

90603

Chen, Tzu-jung LAc

16153 Whittier Blvd

Whittier, CA 90603

(909) 991-6291

gimhealing.com

License: AC18056

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Other Language: Chinese

Cultural Competency: NR

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

216

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

90605

Siegel, Gregory DC

13710 Whittier Blvd Ste 105

Whittier, CA 90605

(562) 945-1310

www.whittierchiropracticacup

uncture.com

License: DC15681

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W,F 9AM-6PM, TU,TH

9AM-6:30PM, SA 8:30AM-11AM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: P, EB, R, 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.

WILMINGTON

90744

Chang, Chung Young LAc

1355 Broad Ave

Wilmington, CA 90744

(310) 684-4466

www.TzuchiMedicalGroup.co

m

License: AC8360

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TU-SA 9AM-6PM

PTA: No

Other Language: Chinese

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Chen, Jeng-shiang LAc

1355 Broad Ave

Wilmington, CA 90744

(310) 684-4466

License: AC10577

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: TU,W,F,SA 9AM-6PM

PTA: No

Other Language: Mandarin

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Lai, Yi-hsien LAc

1355 Broad Ave

Wilmington, CA 90744

(310) 684-4466

License: AC8087

Credentials and/or board

certification: No

Accepting New Members: Yes

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

217

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

Hours: TU-SA 9AM-6PM their accessibility needs when

PTA: No there is limited access or when

Other Language: Chinese accessibility indicators are not Wang, Chiao-nien LAc

Cultural Competency: NR present. 1355 Broad Ave

Accessibility: P, EB, R, W; UPDATE: There was a change Wilmington, CA 90744

Members should call the in the provider record; (310) 684-4466

provider’s office to discuss demographic, phone and/or License: AC4403

their accessibility needs when panel status. Credentials and/or board

there is limited access or when certification: No

accessibility indicators are not Accepting New Members: Yes

present. Lin, Steven LAc Hours: TU,TH-SA 9AM-5PM

UPDATE: There was a change 1355 Broad Ave PTA: No

in the provider record; Wilmington, CA 90744 Other Language: Chinese,

demographic, phone and/or (310) 684-4466 Mandarin

panel status. License: AC14534 Cultural Competency: NR

Credentials and/or board Accessibility: P, EB, R, W;

certification: No Members should call the

Lin, Chi-yi LAc Accepting New Members: Yes provider’s office to discuss

1355 Broad Ave Hours: TU,F 9AM-5PM their accessibility needs when

Wilmington, CA 90744 PTA: No there is limited access or when

(310) 684-4466 Other Language: Chinese, accessibility indicators are not

www.tzuchimedicalfoundatio Mandarin present.

n.org Cultural Competency: NR UPDATE: There was a change

License: AC8867 Accessibility: P, EB, R, W; in the provider record;

Credentials and/or board Members should call the demographic, phone and/or

certification: No provider’s office to discuss panel status.

Accepting New Members: Yes their accessibility needs when

Hours: TU-SA 9AM-5PM there is limited access or when

PTA: No accessibility indicators are not Zwickel, Joseph DC

Other Language: Mandarin present. 1314 N Avalon Blvd Ste A

Cultural Competency: NR UPDATE: There was a change Wilmington, CA 90744

Accessibility: P, EB, R, W; in the provider record; (310) 523-4494

Members should call the demographic, phone and/or License: DC22907

provider’s office to discuss panel status. Credentials and/or board

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

218

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

certification: No

Accepting New Members: Yes

Hours: TU,TH 9AM-6PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: P, EB, R, 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.

WINNETKA

91306

Lee, Sang Wook DC

20061 Saticoy St Ste 101

Winnetka, CA 91306

(747) 206-5288

License: DC34384

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 9AM-6:30PM

PTA: No

Other Language: Korean

Cultural Competency: NR

Accessibility: P, EB, R, 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.

WOODLAND HILLS

91364

Edery, Gabriel DC

22311 Ventura Blvd Ste 116

Woodland Hills, CA 91364

(818) 651-3252

www.drgabyedery.com

License: DC32583

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: SU 9AM-4PM, TU

12:30PM-6PM, TH 8:30AM-6PM,

F 1PM-5:30PM

PTA: No

Other Language: Hebrew

Cultural Competency: NR

Accessibility: P, EB, 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.

Gravelle, Roxana LAc

22600 Ventura Blvd Ste 201

Woodland Hills, CA 91364

(424) 888-0339

http://gentletouchtcm.com

License: AC15150

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Other Language: Spanish

Cultural Competency: NR

Members should call the

provider’s office to discuss

their accessibility needs.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Vigo, Himeno LAc

20300 Ventura Blvd Ste 245

Woodland Hills, CA 91364

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

219

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LOS ANGELES COUNTY ACUPUNCTURE PROVIDERS

(818) 233-0214

kokoroacupuncture.com

License: 18508

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Vu, Hoang LAc;DOM

20121 Ventura Blvd Ste 205

Woodland Hills, CA 91364

(818) 592-0355

www.doctorgu.com

License: AC16311

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M-F 8AM-6PM, SA

8AM-2PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, R, 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.

91367

Brody, Bruce DC

6325 Topanga Canyon Blvd

Ste 225

Woodland Hills, CA 91367

(818) 887-2225

www.brucebrodydc.com

License: DC20925

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,W 8:30AM-6PM, TU

8:30AM-5PM, F 8AM-6PM, SA

8AM-12PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: P, EB, R, 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.

Nikroo, Alireza DC

6200 Canoga Ave Ste 105

Woodland Hills, CA 91367

(818) 222-1120

License: DC33033

Credentials and/or board

certification: No

Accepting New Members: Yes

Hours: M,TH,F 8AM-5PM, W

8AM-8PM

PTA: No

Other Language: Spanish,

Persian

Cultural Competency: NR

Accessibility: P, EB, R, 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: NEW Provider Added.

Effective_Date: 01-MAR-20

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

220

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LOS ANGELES COUNTY MENTAL HEALTH PROVIDERS

AGOURA HILLS

91301

Barrus, Kim PSY

30423 Canwood St Ste 130

Agoura Hills, CA 91301

(818) 707-7366

License: 6155

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: M-SA 8AM-6PM

PTA: No

Other Language: French

Cultural Competency: NR

Accessibility: EB, IB, E, R;

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: Serious

Mental Illness, Co-occuring

Disorders

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

ARCADIA

91006

Dalton, Emily PSY

41 E Foothill Blvd Ste 102

Arcadia, CA 91006

(626) 701-4249

License: 30976

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: SU 10AM-6PM, M-F

8AM-9PM, SA 9AM-9PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, IB, E;

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: 20-AUG-19

Perez, Alicia MFT

41 E Foothill Blvd Ste 102

Arcadia, CA 91006

(626) 701-4249

License: 85602

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: SU 10AM-6PM, M-F

8AM-9PM, SA 9AM-9PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, IB, E;

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: 09-AUG-19

BEVERLY HILLS

90212

Daneshvar, Elenor PSY

9401 Wilshire Blvd Ste 730

Beverly Hills, CA 90212

(310) 707-1526

License: 26586

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: TU,TH 9AM-7PM

PTA: No

Cultural Competency: NR

Accessibility: EB; 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: Serious

Mental Illness

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

221

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LOS ANGELES COUNTY MENTAL HEALTH PROVIDERS

UPDATE: TERMED Provider.

Effective Date: 31-JAN-20

BURBANK

91502

Gomez Falcon, Mariah PSY

217 W Alameda Ave Ste 101

Burbank, CA 91502

(818) 848-5653

License: 14147

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: M,TU,TH 9AM-9PM, W

4:30PM-9PM, F 8:30AM-3PM,

SA 7:30AM-2PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: P; 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-AUG-13

Miller, Jaymie MFT

245 E Olive Ave Ste 400

Burbank, CA 91502

(818) 823-6677

License: 112506

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: SU 9AM-5PM, M-SA

9AM-9PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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: 21-AUG-19

Reyes, Adriana MFT

245 E Olive Ave Ste 400

Burbank, CA 91502

(818) 823-6677

License: 112968

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: SU 9AM-5PM, M-SA

9AM-9PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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: Serious

Mental Illness, Homelessness

UPDATE: NEW Provider Added.

Effective_Date: 31-DEC-19

91505

Corvino, Neva MFT

3808 W Riverside Dr Ste 500

Burbank, CA 91505

(747) 221-9921

License: LMFT100299

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: M,SU 9AM-2PM, TU

3PM-8PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, IB, R;

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: Serious

Mental Illness

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

222

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LOS ANGELES COUNTY MENTAL HEALTH PROVIDERS

UPDATE: NEW Provider Added.

Effective_Date: 30-JUL-19

CERRITOS

90703

Avitabile, John MFT

17326 Edwards Rd Ste A135

Cerritos, CA 90703

(562) 222-5258

License: 100281

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: M-F 9AM-9PM, SA

9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: EB; 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: 31-DEC-19

St. Mary, Gordon PSY

17215 Studebaker Rd Ste 180

Cerritos, CA 90703

(818) 326-3816

License: 17475

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: M,TH 5:30PM-9:30PM,

TU,W 5PM-9:30PM, F

5:30PM-9PM, SA 8AM-7PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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: Physical

Disabilities, Serious Mental

Illness, Deafness or

Hard-of-Hearing, Co-occuring

Disorders

UPDATE: NEW Provider Added.

Effective_Date: 01-AUG-13

CLAREMONT

91711

Abdullatif, Qutayba PSY

201 W 4th St Ste 200

Claremont, CA 91711

(626) 460-1260

License: PSY28804

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Other Language: Arabic

Cultural Competency: NR

Accessibility: P, EB, IB, R;

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: Physical

Disabilities, Chronic Illness,

HIV/AIDS, Serious Mental

Illness, Homelessness, Deafness

or Hard-of-Hearing, Blindness

or Visual Impairment,

Co-occuring Disorders

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Heitz, Andrea CSW

219 N Indian Hill Blvd Ste 101

Claremont, CA 91711

(909) 438-4554

License: 22697

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

223

Page 229: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MENTAL HEALTH PROVIDERS

Hours: SU 11AM-7PM, W,TH

10AM-9PM, F 10AM-4PM, SA

10AM-6PM

PTA: No

Cultural Competency: NR

Accessibility: P, IB, R; 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: Serious

Mental Illness, Co-occuring

Disorders

UPDATE: NEW Provider Added.

Effective_Date: 01-JAN-17

Reed, Kris PSY

219 N Indian Hill Blvd Ste 205

Claremont, CA 91711

(909) 568-4790

License: 16355

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: M 2PM-9PM, TU-TH

5PM-9PM, F 5PM-7PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, IB, R;

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: Serious

Mental Illness

UPDATE: NEW Provider Added.

Effective_Date: 14-JAN-20

Thompson, Judy MFT

540 W Baseline Rd Ste 3

Claremont, CA 91711

(909) 941-4870

License: 86907

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: M-F 8AM-5PM, SA

8AM-2PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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: 18-JUL-18

COVINA

91723

Williams, Carol MFT

540 S Eremland Dr Ste C

Covina, CA 91723

(626) 966-1577

License: 89261

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: M-TH 9AM-7PM, F

9AM-5PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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: Chronic

Illness, Serious Mental Illness

UPDATE: TERMED Provider.

Effective Date: 29-JAN-20

91724

Liang, Kristin PSY

969 S Village Oaks Dr Ste 102

Covina, CA 91724

(626) 722-8118

License: 22902

Credentials and/or board

certification: Not Applicable

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

224

Page 230: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MENTAL HEALTH PROVIDERS

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Other Language: Mandarin,

Yue Chinese, Chinese

Cultural Competency: NR

Accessibility: P, EB; 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: Serious

Mental Illness

UPDATE: NEW Provider Added.

Effective_Date: 20-JAN-20

CULVER CITY

90230

Arkosy, Thomas MFT

5731 W Slauson Ave Ste 220

Culver City, CA 90230

(888) 851-5595

License: 46769

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: SA,SU 8AM-6PM, M

7AM-9:30PM, TU-F 7AM-9PM

PTA: No

Other Language: Hungarian

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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: 17-OCT-18

Berndes Carlson, Teresita MFT

5731 W Slauson Ave Ste 220

Culver City, CA 90230

(888) 851-5595

License: 23575

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: SA,SU 8AM-6PM, M

7AM-9:30PM, TU-F 7AM-9PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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: Serious

Mental Illness

UPDATE: NEW Provider Added.

Effective_Date: 01-AUG-13

Blueskyes, Roman MFT

5731 W Slauson Ave Ste 220

Culver City, CA 90230

(888) 851-5595

License: 43822

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: SA,SU 8AM-6PM, M

7AM-9:30PM, TU-F 7AM-9PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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: Serious

Mental Illness

UPDATE: NEW Provider Added.

Effective_Date: 01-AUG-15

Carroll, Joshua MFT

5731 W Slauson Ave Ste 220

Culver City, CA 90230

(888) 851-5595

License: 91232

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

225

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LOS ANGELES COUNTY MENTAL HEALTH PROVIDERS

Credentials and/or board their accessibility needs when

certification: Not Applicable there is limited access or when Fatato, Antoinette CSW

Accepting New Members: Yes accessibility indicators are not 5731 W Slauson Ave Ste 220

Hours: SA,SU 8AM-6PM, M present. Culver City, CA 90230

7AM-9:30PM, TU-F 7AM-9PM Special Expertise: HIV/AIDS, (888) 851-5595

PTA: No Serious Mental Illness License: LCSW28450

Cultural Competency: NR UPDATE: NEW Provider Added. Credentials and/or board

Accessibility: P, EB, IB, E, R; Effective_Date: 03-APR-18 certification: Not Applicable

Members should call the Accepting New Members: Yes

provider’s office to discuss Hours: SA,SU 8AM-6PM, M

their accessibility needs when Fass, Tara MFT 7AM-9:30PM, TU-F 7AM-9PM

there is limited access or when 5731 W Slauson Ave Ste 220 PTA: No

accessibility indicators are not Culver City, CA 90230 Cultural Competency: NR

present. (888) 851-5595 Accessibility: P, EB, IB, E, R;

UPDATE: NEW Provider Added. License: LMFT35078 Members should call the

Effective_Date: 17-DEC-19 Credentials and/or board provider’s office to discuss

certification: Not Applicable their accessibility needs when

Accepting New Members: Yes there is limited access or when

Claros, John CSW Hours: SA,SU 8AM-6PM, M accessibility indicators are not

5731 W Slauson Ave Ste 220 7AM-9:30PM, TU-F 7AM-9PM present.

Culver City, CA 90230 PTA: No UPDATE: NEW Provider Added.

(888) 851-5595 Cultural Competency: NR Effective_Date: 01-JAN-18

License: 80393 Accessibility: P, EB, IB, E, R;

Credentials and/or board Members should call the

certification: Not Applicable provider’s office to discuss Goldsmith, Steven MD

Accepting New Members: Yes their accessibility needs when 5731 W Slauson Ave Ste 220

Hours: SA,SU 8AM-6PM, M there is limited access or when Culver City, CA 90230

7AM-9:30PM, TU-F 7AM-9PM accessibility indicators are not (888) 851-5595

PTA: No present. License: 19571

Other Language: Spanish Special Expertise: Serious Credentials and/or board

Cultural Competency: NR Mental Illness certification: Not Applicable

Accessibility: P, EB, IB, E, R; UPDATE: NEW Provider Added. Accepting New Members: Yes

Members should call the Effective_Date: 01-AUG-15 Hours: SA,SU 8AM-6PM, M

provider’s office to discuss 7AM-9:30PM, TU-F 7AM-9PM

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

226

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LOS ANGELES COUNTY MENTAL HEALTH PROVIDERS

PTA: No

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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: Chronic

Illness, Serious Mental Illness

UPDATE: NEW Provider Added.

Effective_Date: 15-SEP-17

Hatami, Nazila MFT

5731 W Slauson Ave Ste 220

Culver City, CA 90230

(888) 851-5595

License: LMFT104818

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: SA,SU 8AM-6PM, M

7AM-9:30PM, TU-F 7AM-9PM

PTA: No

Other Language: Persian

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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: Serious

Mental Illness

UPDATE: NEW Provider Added.

Effective_Date: 28-AUG-18

Huang, Lillian MFT

5731 W Slauson Ave Ste 220

Culver City, CA 90230

(888) 851-5595

License: 45064

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: SA,SU 8AM-6PM, M

7AM-9:30PM, TU-F 7AM-9PM

PTA: No

Other Language: Mandarin

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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: Serious

Mental Illness

UPDATE: NEW Provider Added.

Effective_Date: 01-AUG-15

Klamann, Kalina MFT

5731 W Slauson Ave Ste 220

Culver City, CA 90230

(888) 851-5595

License: LMFT47292

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: SA,SU 8AM-6PM, M

7AM-9:30PM, TU-F 7AM-9PM

PTA: No

Other Language: Polish

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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: Serious

Mental Illness

UPDATE: NEW Provider Added.

Effective_Date: 01-MAY-16

Morgan, Michael CSW

5731 W Slauson Ave Ste 220

Culver City, CA 90230

(888) 851-5595

License: 26177

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

227

Page 233: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MENTAL HEALTH PROVIDERS

Hours: SA,SU 8AM-6PM, M their accessibility needs when

7AM-9:30PM, TU-F 7AM-9PM there is limited access or when Suaya, Viviana MD

PTA: No accessibility indicators are not 5731 W Slauson Ave Ste 220

Cultural Competency: NR present. Culver City, CA 90230

Accessibility: P, EB, IB, E, R; UPDATE: NEW Provider Added. (888) 851-5595

Members should call the Effective_Date: 31-DEC-19 License: A52516

provider’s office to discuss Credentials and/or board

their accessibility needs when certification: Not Applicable

there is limited access or when Sheiniuk, Robyn CSW Accepting New Members: Yes

accessibility indicators are not 5731 W Slauson Ave Ste 220 Hours: SA,SU 8AM-6PM, M

present. Culver City, CA 90230 7AM-9:30PM, TU-F 7AM-9PM

Special Expertise: Serious (888) 851-5595 PTA: No

Mental Illness, Co-occuring License: 18990 Other Language: Spanish

Disorders Credentials and/or board Cultural Competency: NR

UPDATE: NEW Provider Added. certification: Not Applicable Accessibility: P, EB, IB, E, R;

Effective_Date: 15-APR-17 Accepting New Members: Yes Members should call the

Hours: SA,SU 8AM-6PM, M provider’s office to discuss

7AM-9:30PM, TU-F 7AM-9PM their accessibility needs when

Saucedo, Ruth PSY PTA: No there is limited access or when

5731 W Slauson Ave Ste 220 Cultural Competency: NR accessibility indicators are not

Culver City, CA 90230 Accessibility: P, EB, IB, E, R; present.

(888) 851-5595 Members should call the Special Expertise: Serious

License: 30908 provider’s office to discuss Mental Illness

Credentials and/or board their accessibility needs when UPDATE: NEW Provider Added.

certification: Not Applicable there is limited access or when Effective_Date: 15-JUL-15

Accepting New Members: Yes accessibility indicators are not

Hours: SA,SU 8AM-6PM, M present.

7AM-9:30PM, TU-F 7AM-9PM Special Expertise: Chronic Yocum, Jacqueline CSW

PTA: No Illness, HIV/AIDS, Serious 5731 W Slauson Ave Ste 220

Other Language: Spanish Mental Illness, Co-occuring Culver City, CA 90230

Cultural Competency: NR Disorders (888) 851-5595

Accessibility: P, EB, IB, E, R; UPDATE: NEW Provider Added. License: 27389

Members should call the Effective_Date: 01-OCT-15 Credentials and/or board

provider’s office to discuss certification: Not Applicable

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

228

Page 234: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MENTAL HEALTH PROVIDERS

Accepting New Members: Yes

Hours: SA,SU 8AM-6PM, M

7AM-9:30PM, TU-F 7AM-9PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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: Serious

Mental Illness

UPDATE: NEW Provider Added.

Effective_Date: 17-OCT-18

DOWNEY

90242

Atanasio, Joseph PSY

12023 Lakewood Blvd

Downey, CA 90242

(562) 904-3999

License: 28201

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Cultural Competency: NR

Members should call the

provider’s office to discuss

their accessibility needs.

UPDATE: TERMED Provider.

Effective Date: 04-FEB-20

ENCINO

91316

Attento, Adriana MFT

17777 Ventura Blvd Ste 105

Encino, CA 91316

(213) 908-1234

License: 107387

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: SA,SU 8AM-10PM, M-F

7:30AM-10PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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: Serious

Mental Illness

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Brody, Dora MFT

17777 Ventura Blvd Ste 105

Encino, CA 91316

(213) 908-1234

License: LCSW84925

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: SA,SU 8AM-10PM, M-F

7:30AM-10PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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,

Serious Mental Illness

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Deak, Gabi CSW

17777 Ventura Blvd Ste 105

Encino, CA 91316

(213) 908-1234

License: LCSW23059

Credentials and/or board

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

229

Page 235: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MENTAL HEALTH PROVIDERS

certification: Not Applicable Accessibility: P, EB, IB, E, R; present.

Accepting New Members: Yes Members should call the UPDATE: There was a change

Hours: SA,SU 8AM-10PM, M-F provider’s office to discuss in the provider record;

7:30AM-10PM their accessibility needs when demographic, phone and/or

PTA: No there is limited access or when panel status.

Other Language: Arabic accessibility indicators are not

Cultural Competency: NR present.

Accessibility: P, EB, IB, E, R; Special Expertise: Serious Gershelis, Anna CSW

Members should call the Mental Illness 17777 Ventura Blvd Ste 105

provider’s office to discuss UPDATE: There was a change Encino, CA 91316

their accessibility needs when in the provider record; (213) 908-1234

there is limited access or when demographic, phone and/or License: 28777

accessibility indicators are not panel status. Credentials and/or board

present. certification: Not Applicable

Special Expertise: Serious Accepting New Members: Yes

Mental Illness Fruchtbaum, Irene PSY Hours: SA,SU 8AM-10PM, M-F

UPDATE: There was a change 17777 Ventura Blvd Ste 105 7:30AM-10PM

in the provider record; Encino, CA 91316 PTA: No

demographic, phone and/or (213) 908-1234 Other Language: Russian

panel status. License: 18821 Cultural Competency: NR

Credentials and/or board Accessibility: P, EB, IB, E, R;

certification: Not Applicable Members should call the

Frank, Jennifer PSY Accepting New Members: Yes provider’s office to discuss

17777 Ventura Blvd Ste 105 Hours: SA,SU 8AM-10PM, M-F their accessibility needs when

Encino, CA 91316 7:30AM-10PM there is limited access or when

(213) 908-1234 PTA: No accessibility indicators are not

License: PSY30175 Other Language: Russian present.

Credentials and/or board Cultural Competency: NR Special Expertise: Serious

certification: Not Applicable Accessibility: P, EB, IB, E, R; Mental Illness

Accepting New Members: Yes Members should call the UPDATE: There was a change

Hours: SA,SU 8AM-10PM, M-F provider’s office to discuss in the provider record;

7:30AM-10PM their accessibility needs when demographic, phone and/or

PTA: No there is limited access or when panel status.

Cultural Competency: NR accessibility indicators are not

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

230

Page 236: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MENTAL HEALTH PROVIDERS

Hours: SA,SU 8AM-10PM, M-F provider’s office to discuss

Grazer, Sage CSW 7:30AM-10PM their accessibility needs when

17777 Ventura Blvd Ste 105 PTA: No there is limited access or when

Encino, CA 91316 Other Language: Armenian accessibility indicators are not

(213) 908-1234 Cultural Competency: NR present.

License: LCSW76690 Accessibility: P, EB, IB, E, R; Special Expertise: Chronic

Credentials and/or board Members should call the Illness

certification: Not Applicable provider’s office to discuss UPDATE: There was a change

Accepting New Members: Yes their accessibility needs when in the provider record;

Hours: SA,SU 8AM-10PM, M-F there is limited access or when demographic, phone and/or

7:30AM-10PM accessibility indicators are not panel status.

PTA: No present.

Cultural Competency: NR Special Expertise: Serious

Accessibility: P, EB, IB, E, R; Mental Illness Kaiser, William PSY

Members should call the UPDATE: There was a change 17777 Ventura Blvd Ste 105

provider’s office to discuss in the provider record; Encino, CA 91316

their accessibility needs when demographic, phone and/or (213) 908-1234

there is limited access or when panel status. License: 13221

accessibility indicators are not Credentials and/or board

present. certification: Not Applicable

UPDATE: There was a change Johnson Boykin, Kim PSY Accepting New Members: Yes

in the provider record; 17777 Ventura Blvd Ste 105 Hours: SA,SU 8AM-10PM, M-F

demographic, phone and/or Encino, CA 91316 7:30AM-10PM

panel status. (213) 908-1234 PTA: No

License: 16047 Cultural Competency: NR

Credentials and/or board Accessibility: P, EB, IB, E, R;

Jingozian, Vardui MFT certification: Not Applicable Members should call the

17777 Ventura Blvd Ste 105 Accepting New Members: Yes provider’s office to discuss

Encino, CA 91316 Hours: SA,SU 8AM-10PM, M-F their accessibility needs when

(213) 908-1234 7:30AM-10PM there is limited access or when

License: LMFT97722 PTA: No accessibility indicators are not

Credentials and/or board Cultural Competency: NR present.

certification: Not Applicable Accessibility: P, EB, IB, E, R; Special Expertise: Serious

Accepting New Members: Yes Members should call the Mental Illness

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

231

Page 237: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MENTAL HEALTH PROVIDERS

UPDATE: There was a change Encino, CA 91316 PTA: No

in the provider record; (213) 908-1234 Other Language: Persian

demographic, phone and/or License: LMFT101316 Cultural Competency: NR

panel status. Credentials and/or board Accessibility: P, EB, IB, E, R;

certification: Not Applicable Members should call the

Accepting New Members: Yes provider’s office to discuss

Kaplansky, Galina MFT Hours: SA,SU 8AM-10PM, M-F their accessibility needs when

17514 Ventura Blvd Ste 7:30AM-10PM there is limited access or when

100-101 PTA: No accessibility indicators are not

Encino, CA 91316 Other Language: Armenian present.

(310) 877-0600 Cultural Competency: NR Special Expertise: Serious

License: 77151 Accessibility: P, EB, IB, E, R; Mental Illness

Credentials and/or board Members should call the UPDATE: There was a change

certification: Not Applicable provider’s office to discuss in the provider record;

Accepting New Members: Yes their accessibility needs when demographic, phone and/or

Hours: M 9AM-8:30PM, TU,TH there is limited access or when panel status.

9AM-10PM, W 9AM-10:30PM, F accessibility indicators are not

9AM-9:30PM, SA 11AM-6PM present.

PTA: No UPDATE: There was a change Krinsky Atkins, Leah MFT

Other Language: Russian in the provider record; 17777 Ventura Blvd Ste 105

Cultural Competency: NR demographic, phone and/or Encino, CA 91316

Accessibility: EB, IB, E, R; panel status. (213) 908-1234

Members should call the License: 81396

provider’s office to discuss Credentials and/or board

their accessibility needs when Kooklan, Fariba MFT certification: Not Applicable

there is limited access or when 17777 Ventura Blvd Ste 105 Accepting New Members: Yes

accessibility indicators are not Encino, CA 91316 Hours: SA,SU 8AM-10PM, M-F

present. (213) 908-1234 7:30AM-10PM

UPDATE: NEW Provider Added. License: 45702 PTA: No

Effective_Date: 21-JAN-20 Credentials and/or board Cultural Competency: NR

certification: Not Applicable Accessibility: P, EB, IB, E, R;

Accepting New Members: Yes Members should call the

Khachatryan, Shushanik MFT Hours: SA,SU 8AM-10PM, M-F provider’s office to discuss

17777 Ventura Blvd Ste 105 7:30AM-10PM their accessibility needs when

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

232

Page 238: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MENTAL HEALTH PROVIDERS

there is limited access or when

accessibility indicators are not

present.

Special Expertise: Serious

Mental Illness, Co-occuring

Disorders

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Leonard, Elisa CSW

17777 Ventura Blvd Ste 105

Encino, CA 91316

(213) 908-1234

License: LCSW23997

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: SA,SU 8AM-10PM, M-F

7:30AM-10PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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.

Martin, Silvana MFT

17777 Ventura Blvd Ste 105

Encino, CA 91316

(213) 908-1234

License: MFC47088

Accepting New Members: Yes

Hours: SA,SU 8AM-10PM, M-F

7:30AM-10PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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.

Parodi, Jacqueline CSW

17777 Ventura Blvd Ste 105

Encino, CA 91316

(213) 908-1234

License: 22172

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: SA,SU 8AM-10PM, M-F

7:30AM-10PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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: Serious

Mental Illness

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Perlman, Jonathan CSW

17777 Ventura Blvd Ste 105

Encino, CA 91316

(213) 908-1234

License: 77031

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: SA,SU 8AM-10PM, M-F

7:30AM-10PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

Members should call the

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

233

Page 239: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MENTAL HEALTH PROVIDERS

provider’s office to discuss

their accessibility needs when

there is limited access or when

accessibility indicators are not

present.

Special Expertise: Serious

Mental Illness

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Quinones, Meisha MFT

17777 Ventura Blvd Ste 105

Encino, CA 91316

(213) 908-1234

License: LMFT106290

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: SA,SU 8AM-10PM, M-F

7:30AM-10PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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: Serious

Mental Illness

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Rubish, Donald PSY

17777 Ventura Blvd Ste 105

Encino, CA 91316

(213) 908-1234

License: PSY4157

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: SA,SU 8AM-10PM, M-F

7:30AM-10PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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: Serious

Mental Illness, Co-occuring

Disorders

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Sandino, Lisa MFT

5535 Balboa Blvd Ste 100

Encino, CA 91316

(818) 934-0050

License: 95072

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: M-F 9AM-5PM

PTA: No

Cultural Competency: NR

Members should call the

provider’s office to discuss

their accessibility needs.

UPDATE: NEW Provider Added.

Effective_Date: 07-JAN-20

Sandler, Anita MFT

17777 Ventura Blvd Ste 105

Encino, CA 91316

(213) 908-1234

License: 38555

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: SA,SU 8AM-10PM, M-F

7:30AM-10PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

Members should call the

provider’s office to discuss

their accessibility needs when

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

234

Page 240: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MENTAL HEALTH PROVIDERS

there is limited access or when

accessibility indicators are not

present.

Special Expertise: Serious

Mental Illness

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Schwartz, Sarah PSY

17777 Ventura Blvd Ste 105

Encino, CA 91316

(213) 908-1234

License: 23574

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: SA,SU 8AM-10PM, M-F

7:30AM-10PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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: Serious

Mental Illness, Co-occuring

Disorders

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Stevens, Cynthia PSY

17777 Ventura Blvd Ste 105

Encino, CA 91316

(213) 908-1234

License: PAY8926

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: SA,SU 8AM-10PM, M-F

7:30AM-10PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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.

Stevens, Megan MFT

17777 Ventura Blvd Ste 105

Encino, CA 91316

(213) 908-1234

License: LMFT106159

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: SA,SU 8AM-10PM, M-F

7:30AM-10PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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,

Serious Mental Illness,

Co-occuring Disorders

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Ufano Leon, Jeremee CSW

17777 Ventura Blvd Ste 105

Encino, CA 91316

(213) 908-1234

License: 24624

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

235

Page 241: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MENTAL HEALTH PROVIDERS

Hours: SA,SU 8AM-10PM, M-F

7:30AM-10PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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: Serious

Mental Illness

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Yulzari, Lee MFT

17777 Ventura Blvd Ste 105

Encino, CA 91316

(213) 908-1234

License: 112653

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: SA,SU 8AM-10PM, M-F

7:30AM-10PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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: Serious

Mental Illness

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

GLENDALE

91202

Oh, Agnes PSY

1010 N Central Ave # 315

Glendale, CA 91202

(818) 441-1096

License: 23845

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Other Language: Korean

Cultural Competency: NR

Accessibility: EB, IB, E, R;

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: Serious

Mental Illness

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

GLENDORA

91741

Avci, Dilek MD

210 S Grand Ave Ste 320

Glendora, CA 91741

(626) 335-1919

License: A141978

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: M-F 9AM-5PM

PTA: No

Other Language: Turkish

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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: Serious

Mental Illness, Co-occuring

Disorders

UPDATE: TERMED Provider.

Effective Date: 29-JAN-20

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

236

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LOS ANGELES COUNTY MENTAL HEALTH PROVIDERS

LANCASTER

93534

Lewis, Page PSY

1817 W Avenue K Ste 207

Lancaster, CA 93534

(661) 400-2342

License: 11786

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Cultural Competency: NR

Accessibility: P, EB, IB, R;

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: Serious

Mental Illness

UPDATE: NEW Provider Added.

Effective_Date: 14-JAN-20

Torres, Judith MFT

1652 W Avenue J

Lancaster, CA 93534

(661) 249-6720

License: 86924

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: M-TH 9AM-6PM, F,SA

8AM-6PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: P; 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: Serious

Mental Illness

UPDATE: NEW Provider Added.

Effective_Date: 26-DEC-19

LONG BEACH

90804

Abjelina, Kenneth MD

5199 E Pacific Coast Hwy Ste

330n

Long Beach, CA 90804

(562) 365-2020

License: A64789

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: M,TH,F 9AM-7PM,

TU,W,SA 9AM-6PM

PTA: No

Other Language: Tagalog

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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: Serious

Mental Illness

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Abjelina, Kenneth MD

5199 E Pacific Coast Hwy Ste

330n

Long Beach, CA 90804

(562) 365-2020

License: A64789

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: M,TU,TH,F 9AM-7PM, W

9AM-9PM, SA 9AM-6PM

PTA: No

Other Language: Tagalog

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

Members should call the

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

237

Page 243: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MENTAL HEALTH PROVIDERS

provider’s office to discuss

their accessibility needs when

there is limited access or when

accessibility indicators are not

present.

Special Expertise: Serious

Mental Illness

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Iskandar, Lucy MFT

5199 E Pacific Coast Hwy Ste

330n

Long Beach, CA 90804

(562) 365-2020

License: 50579

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: M,TU,TH,F 9AM-7PM, W

9AM-9PM, SA 9AM-6PM

PTA: No

Other Language: Arabic

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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: Serious

Mental Illness

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Paramo, Melissa MFT

5199 E Pacific Coast Hwy Ste

330n

Long Beach, CA 90804

(562) 365-2020

License: 51549

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: M,TU,TH,F 9AM-7PM, W

9AM-9PM, SA 9AM-6PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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: Serious

Mental Illness, Co-occuring

Disorders

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Paul, Mariam MFT

5199 E Pacific Coast Hwy Ste

330n

Long Beach, CA 90804

(562) 365-2020

License: 15544

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: M,TU,TH,F 9AM-7PM, W

9AM-9PM, SA 9AM-6PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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: Serious

Mental Illness

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Wells, Trevor MD

5199 E Pacific Coast Hwy Ste

330n

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

238

Page 244: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

LOS ANGELES COUNTY MENTAL HEALTH PROVIDERS

Long Beach, CA 90804

(562) 365-2020

License: A119988

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: M,TH,F 9AM-7PM,

TU,W,SA 9AM-6PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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: Serious

Mental Illness

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

90807

Dugan, Jennifer PSY

4401 Atlantic Ave Ste 220

Long Beach, CA 90807

(310) 621-0335

License: PSY13736

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Cultural Competency: NR

Accessibility: P, IB, R; 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,

Serious Mental Illness

UPDATE: NEW Provider Added.

Effective_Date: 25-SEP-18

Keo, Samuel PSY

3711 Long Beach Blvd Ste

1016d

Long Beach, CA 90807

(562) 661-3656

License: 23572

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: SU 9AM-12PM

PTA: No

Other Language: Khmer

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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: Serious

Mental Illness, Co-occuring

Disorders

UPDATE: NEW Provider Added.

Effective_Date: 01-JAN-14

Monroe, Trevor PSY

4401 Atlantic Ave # 2

Long Beach, CA 90807

(562) 728-4565

License: 16406

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Cultural Competency: NR

Accessibility: EB; 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: Serious

Mental Illness, Co-occuring

Disorders

UPDATE: There was a change

in the provider record;

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

239

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LOS ANGELES COUNTY MENTAL HEALTH PROVIDERS

demographic, phone and/or

panel status.

90813

Dushenko, Terrance PSY

1045 Atlantic Ave Ste 806

Long Beach, CA 90813

(562) 590-5594

License: 8397

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: M-TH 9AM-7PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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: Serious

Mental Illness

UPDATE: NEW Provider Added.

Effective_Date: 01-JAN-14

90814

Brittain, Debra CSW

350 Redondo Ave Fl 2

Long Beach, CA 90814

(562) 599-9233

License: 22301

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Cultural Competency: NR

Members should call the

provider’s office to discuss

their accessibility needs.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

90815

Griffin, Dominique NPA

4525 E Atherton St # 2

Long Beach, CA 90815

(562) 961-0155

License: 95009310

Credentials and/or board

certification: Not Available

Accepting New Members: Yes

Hours: M-F 8AM-5:30PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, IB, R;

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: 26-DEC-19

LOS ANGELES

90010

Nesovic, Slobodan PSY

4929 Wilshire Blvd Ste 510

Los Angeles, CA 90010

(760) 300-3664

License: 28761

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: M-SU 7AM-7PM

PTA: No

Other Language: Bosnian,

Serbo-Croatian

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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: Chronic

Illness

UPDATE: NEW Provider Added.

Effective_Date: 14-JAN-20

Sandberg, Joan PSY

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

240

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LOS ANGELES COUNTY MENTAL HEALTH PROVIDERS

4929 Wilshire Blvd Ste 510

Los Angeles, CA 90010

(760) 300-3664

License: 12425

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: M-SU 7AM-7PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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: Chronic

Illness

UPDATE: NEW Provider Added.

Effective_Date: 14-JAN-20

90041

Barnett, Chalon CSW

2373 Colorado Blvd

Los Angeles, CA 90041

(562) 904-3999

License: 87431

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Cultural Competency: NR

Members should call the

provider’s office to discuss

their accessibility needs.

UPDATE: NEW Provider Added.

Effective_Date: 18-SEP-19

Mendonsa, Andrew PSY

2373 Colorado Blvd

Los Angeles, CA 90041

(562) 904-3999

License: 23208

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Cultural Competency: NR

Members should call the

provider’s office to discuss

their accessibility needs.

UPDATE: NEW Provider Added.

Effective_Date: 18-SEP-19

90044

Eipl, Kristina MD

10024 S Vermont Ave

Los Angeles, CA 90044

(323) 756-1412

License: A158218

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: M-F 8AM-6PM, SA

8AM-4PM

PTA: No

Other Language: Afrikaans,

French, Spanish, Vietnamese

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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: Serious

Mental Illness, Homelessness

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

90047

Hefley, Priscilla MFT

1704 W Manchester Ave Ste

202a

Los Angeles, CA 90047

(424) 312-2311

License: ACSW79866

Credentials and/or board

certification: Not Available

Accepting New Members: Yes

Hours: SU 8AM-4PM, M-F

8AM-8PM, SA 8AM-4:30PM

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

241

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LOS ANGELES COUNTY MENTAL HEALTH PROVIDERS

PTA: No

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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.

Ifekwunigwe, Christopher CSW

1704 W Manchester Ave Ste

202a

Los Angeles, CA 90047

(424) 312-2311

License: 19633

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: SU 8AM-4PM, M-F

8AM-8PM, SA 8AM-4:30PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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: Serious

Mental Illness, Co-occuring

Disorders

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Mclafferty, Joel MFT

1704 W Manchester Ave Ste

202a

Los Angeles, CA 90047

(424) 312-2311

License: 43113

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: SU 8AM-4PM, M-F

8AM-8PM, SA 8AM-4:30PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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: Serious

Mental Illness

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Patterson, Kala CSW

1704 W Manchester Ave Ste

202a

Los Angeles, CA 90047

(424) 312-2311

License: ACSW87251

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: SU 8AM-4PM, M-F

8AM-8PM, SA 8AM-4:30PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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,

Serious Mental Illness,

Co-occuring Disorders

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

242

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LOS ANGELES COUNTY MENTAL HEALTH PROVIDERS

Ramos Montelongo, Flor CSW

1704 W Manchester Ave Ste

202a

Los Angeles, CA 90047

(424) 312-2311

License: 84224

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: SU 8AM-4PM, M-F

8AM-8PM, SA 8AM-4:30PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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: Serious

Mental Illness

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Sardin, Divinity MFT

1704 W Manchester Ave Ste

202a

Los Angeles, CA 90047

(424) 312-2311

License: 70351

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: SU 8AM-4PM, M-F

8AM-8PM, SA 8AM-4:30PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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.

90064

Chuman, Brandon PSY

11835 W Olympic Blvd Ste

1265e

Los Angeles, CA 90064

(310) 273-4843

License: 28338

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: M-SU 8AM-6PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, IB, R;

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: Physical

Disabilities, Serious Mental

Illness, Deafness or

Hard-of-Hearing

UPDATE: TERMED Provider.

Effective Date: 24-FEB-20

Chuman, Brandon PSY

10801 National Blvd

Los Angeles, CA 90064

(310) 273-4843

License: 28338

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: M-F 8AM-6PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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: Physical

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

243

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LOS ANGELES COUNTY MENTAL HEALTH PROVIDERS

Disabilities, Serious Mental

Illness, Deafness or

Hard-of-Hearing

UPDATE: TERMED Provider.

Effective Date: 24-FEB-20

MARINA DEL REY

90292

Seiden, Rita CSW

4519 Admiralty Way Ste 200

Marina Del Rey, CA 90292

(718) 415-8213

License: 28925

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: M 12PM-8PM, TU,TH

9AM-8PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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: Serious

Mental Illness

UPDATE: NEW Provider Added.

Effective_Date: 01-AUG-13

MONROVIA

91016

Ammen, Magena MFT

1333 S Mayflower Ave Ste 360

Monrovia, CA 91016

(626) 701-4249

License: 102661

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: M-F 9AM-9PM, SA

9AM-4PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: EB; 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: Serious

Mental Illness, Co-occuring

Disorders

UPDATE: NEW Provider Added.

Effective_Date: 23-OCT-19

Avila, Adriana MFT

1333 S Mayflower Ave Ste 360

Monrovia, CA 91016

(626) 701-4249

License: 116562

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: M-F 9AM-9PM, SA

9AM-4PM

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: EB; 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: Serious

Mental Illness

UPDATE: NEW Provider Added.

Effective_Date: 01-JAN-20

Dalton, Emily PSY

1333 S Mayflower Ave Ste 360

Monrovia, CA 91016

(626) 701-4249

License: 30976

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: M-F 9AM-9PM, SA

9AM-4PM

PTA: No

Cultural Competency: NR

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

244

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LOS ANGELES COUNTY MENTAL HEALTH PROVIDERS

Accessibility: EB; Members Greener, Michael CSW Hours: M-F 9AM-9PM, SA

should call the provider’s 1333 S Mayflower Ave Ste 360 9AM-4PM

office to discuss their Monrovia, CA 91016 PTA: No

accessibility needs when there (626) 701-4249 Other Language: Armenian

is limited access or when License: LCSW83054 Cultural Competency: NR

accessibility indicators are not Credentials and/or board Accessibility: EB; Members

present. certification: Not Applicable should call the provider’s

UPDATE: NEW Provider Added. Accepting New Members: Yes office to discuss their

Effective_Date: 23-OCT-19 Hours: M-F 9AM-9PM, SA accessibility needs when there

9AM-4PM is limited access or when

PTA: No accessibility indicators are not

Gaeta, Yadira MFT Cultural Competency: NR present.

1333 S Mayflower Ave Ste 360 Accessibility: EB; Members Special Expertise: HIV/AIDS,

Monrovia, CA 91016 should call the provider’s Serious Mental Illness,

(626) 701-4249 office to discuss their Co-occuring Disorders

License: 111547 accessibility needs when there UPDATE: NEW Provider Added.

Credentials and/or board is limited access or when Effective_Date: 23-OCT-19

certification: Not Applicable accessibility indicators are not

Accepting New Members: Yes present.

Hours: M-F 9AM-9PM, SA Special Expertise: Serious Perez, Alicia MFT

9AM-4PM Mental Illness 1333 S Mayflower Ave Ste 360

PTA: No UPDATE: NEW Provider Added. Monrovia, CA 91016

Cultural Competency: NR Effective_Date: 23-OCT-19 (626) 701-4249

Accessibility: EB; Members License: 85602

should call the provider’s Credentials and/or board

office to discuss their Hacopians, Sareen MFT certification: Not Applicable

accessibility needs when there 1333 S Mayflower Ave Ste 360 Accepting New Members: Yes

is limited access or when Monrovia, CA 91016 Hours: M-F 9AM-9PM, SA

accessibility indicators are not (626) 701-4249 9AM-4PM

present. License: LMFT110067 PTA: No

UPDATE: NEW Provider Added. Credentials and/or board Cultural Competency: NR

Effective_Date: 23-OCT-19 certification: Not Applicable Accessibility: EB; Members

Accepting New Members: Yes should call the provider’s

office to discuss their

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

245

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LOS ANGELES COUNTY MENTAL HEALTH PROVIDERS

accessibility needs when there

is limited access or when

accessibility indicators are not

present.

UPDATE: NEW Provider Added.

Effective_Date: 23-OCT-19

Ruiz, Jessica MFT

1333 S Mayflower Ave Ste 360

Monrovia, CA 91016

(626) 701-4249

License: 111115

Accepting New Members: Yes

Hours: M-F 9AM-9PM, SA

9AM-4PM

PTA: No

Cultural Competency: NR

Accessibility: EB; 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: 23-OCT-19

Santana, Leslie MFT

1333 S Mayflower Ave Ste 360

Monrovia, CA 91016

(626) 701-4249

License: 111270

Accepting New Members: Yes

Hours: M-F 9AM-9PM, SA

9AM-4PM

PTA: No

Cultural Competency: NR

Accessibility: EB; 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: 23-OCT-19

MONTEBELLO

90640

Rivera, Ernest PSY

1623 Paramount Blvd

Montebello, CA 90640

(323) 722-8744

License: 1046

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Other Language: Spanish

Cultural Competency: NR

Accessibility: P, IB, R; 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: Serious

Mental Illness

UPDATE: NEW Provider Added.

Effective_Date: 01-AUG-13

PALMDALE

93550

Burnett, Melissa CSW

38345 30th St E Ste E5

Palmdale, CA 93550

(661) 267-9950

License: 89084

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: M,W-F 9AM-4PM, TU

8AM-4PM, SA 10AM-3PM

PTA: No

Cultural Competency: NR

Accessibility: EB; 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: 31-DEC-19

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

246

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LOS ANGELES COUNTY MENTAL HEALTH PROVIDERS

PASADENA

91105

Mathews, Jane NPA

200 E Del Mar Blvd Ste 122

Pasadena, CA 91105

(626) 578-7111

License: 306620

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: M,TU,F 8AM-7PM, W

9AM-7PM, TH 9AM-8PM, SA

7AM-6:30PM

PTA: No

Other Language: Finnish

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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: Serious

Mental Illness

UPDATE: NEW Provider Added.

Effective_Date: 17-DEC-19

Piccirillo, Vincenzo PSY

200 E Del Mar Blvd Ste 122

Pasadena, CA 91105

(626) 578-7111

License: 28240

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: M,TU,F 8AM-7PM, W

9AM-7PM, TH 9AM-8PM, SA

7AM-6:30PM

PTA: No

Other Language: French,

Italian, Portuguese, Spanish

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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: Serious

Mental Illness, Homelessness,

Co-occuring Disorders

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

91106

Abdullatif, Qutayba PSY

1000 E Walnut St Ste 206

Pasadena, CA 91106

(626) 460-1260

License: PSY28804

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Other Language: Arabic

Cultural Competency: NR

Accessibility: P, EB, IB, R;

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: Physical

Disabilities, Chronic Illness,

HIV/AIDS, Serious Mental

Illness, Homelessness, Deafness

or Hard-of-Hearing, Blindness

or Visual Impairment,

Co-occuring Disorders

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Grattan, Gil PSY

1000 E Walnut St Ste 205

Pasadena, CA 91106

(818) 317-8866

License: 25878

Credentials and/or board

certification: Not Applicable

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

247

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LOS ANGELES COUNTY MENTAL HEALTH PROVIDERS

Accepting New Members: Yes

Hours: SA 9AM-7PM

PTA: No

Cultural Competency: NR

Accessibility: EB; 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: Serious

Mental Illness

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

91107

Terschluse, Lauren MFT

482 N Rosemead Blvd Ste 103

Pasadena, CA 91107

(626) 372-1999

License: 105861

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: M-F 9AM-9PM, SA

9AM-4PM

PTA: No

Cultural Competency: NR

Accessibility: EB; 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: 14-JAN-20

POMONA

91766

Hallbrooks, Landon CSW

435 W Mission Blvd Ste 301

Pomona, CA 91766

(951) 850-1574

License: 88676

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: TU,W 9AM-7PM, F

12PM-7PM, SA 11AM-2PM

PTA: No

Cultural Competency: NR

Accessibility: P, IB, R; 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: 14-JAN-20

91767

Brennecke, Bernadette CSW

2055 N Garey Ave Ste 10

Pomona, CA 91767

(909) 263-0851

License: 10677

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: M-TH 9AM-7PM, F

9AM-4PM

PTA: No

Cultural Competency: NR

Accessibility: P, IB, R; 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: Serious

Mental Illness

UPDATE: NEW Provider Added.

Effective_Date: 01-AUG-13

Petropoulos, Greg MFT

2055 N Garey Ave Ste 10

Pomona, CA 91767

(909) 263-0851

License: 37681

Credentials and/or board

certification: Not Applicable

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

248

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LOS ANGELES COUNTY MENTAL HEALTH PROVIDERS

Accepting New Members: Yes

Hours: M-TH 9AM-7PM, F

9AM-4PM

PTA: No

Cultural Competency: NR

Accessibility: P, IB, R; 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: Serious

Mental Illness

UPDATE: NEW Provider Added.

Effective_Date: 01-AUG-13

SANTA MONICA

90405

Barthol, Sara CSW

2665 30th St Ste 204

Santa Monica, CA 90405

(310) 422-6338

License: 18733

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: M 7AM-2PM, TU,TH

7:30AM-4:30PM, W

7:30AM-12PM, F

7:30AM-5:30PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB; 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 PASADENA

91030

Poon, Pak MFT

1015 Fremont Ave 2nd Fl

South Pasadena, CA 91030

(626) 693-7823

License: LMFT105218

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: M-SU 8AM-8PM

PTA: No

Other Language: Yue Chinese

Cultural Competency: NR

Members should call the

provider’s office to discuss

their accessibility needs.

Special Expertise: Physical

Disabilities, HIV/AIDS, Serious

Mental Illness, Deafness or

Hard-of-Hearing, Co-occuring

Disorders

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Wong, Justin MFT

1015 Fremont Ave 2nd Fl

South Pasadena, CA 91030

(626) 693-7823

License: 89992

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: M-SU 8AM-8PM

PTA: No

Cultural Competency: NR

Members should call the

provider’s office to discuss

their accessibility needs.

Special Expertise: Serious

Mental Illness

UPDATE: NEW Provider Added.

Effective_Date: 23-JAN-20

TARZANA

91356

Hemans, Nichole CSW

18663 Ventura Blvd Ste 232

Tarzana, CA 91356

(323) 371-6242

License: 60950

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

249

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LOS ANGELES COUNTY MENTAL HEALTH PROVIDERS

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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: Serious

Mental Illness, Co-occuring

Disorders

UPDATE: NEW Provider Added.

Effective_Date: 01-JAN-17

TORRANCE

90505

Cearfoss, Christine CSW

23717 Hawthorne Blvd Ste 103

Torrance, CA 90505

(310) 302-7006

License: 25819

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: SU 2PM-5PM, M-TH

11AM-9:30PM, F 11AM-9PM, SA

10AM-3:30PM

PTA: No

Cultural Competency: NR

Accessibility: EB, IB, E, R;

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,

Serious Mental Illness

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Ntung, Helen NPA

23700 Camino Del Sol

Torrance, CA 90505

(310) 530-1151

License: 95008000

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Cultural Competency: NR

Accessibility: P, IB, R; 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: Serious

Mental Illness

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

VAN NUYS

91406

Hopkins, Adrian MFT

16461 Sherman Way Ste 155

Van Nuys, CA 91406

(888) 795-4337

License: 108998

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: M-SA 7AM-10PM

PTA: No

Other Language: Yue Chinese

Cultural Competency: NR

Accessibility: P, IB, R; 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: 07-JAN-20

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

250

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LOS ANGELES COUNTY MENTAL HEALTH PROVIDERS

91411

Goldstein, Estelle MD

14541 Delano St

Van Nuys, CA 91411

(310) 515-8113

License: C50226

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: M-F 9AM-5PM, SA

7AM-2PM

PTA: No

Other Language: French,

Spanish, Yiddish

Cultural Competency: NR

Accessibility: P, EB, IB, E;

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,

Serious Mental Illness,

Co-occuring Disorders

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Heidenfelder, Richard MD

14541 Delano St

Van Nuys, CA 91411

(310) 515-8113

License: A79836

Accepting New Members: Yes

Hours: M-F 9AM-5PM, SA

7AM-2PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, IB, E;

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.

Morante, Pedro NPA

14541 Delano St

Van Nuys, CA 91411

(310) 515-8113

License: 95004061

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: M-F 9AM-5PM, SA

7AM-2PM

PTA: No

Other Language: Tagalog

Cultural Competency: NR

Accessibility: P, EB, IB, E;

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: Serious

Mental Illness

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Sczesny, Andrea NPA

14541 Delano St

Van Nuys, CA 91411

(310) 515-8113

License: 95004889

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: M-F 9AM-5PM, SA

7AM-2PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, IB, E;

Members should call the

provider’s office to discuss

their accessibility needs when

there is limited access or when

accessibility indicators are not

present.

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

251

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LOS ANGELES COUNTY MENTAL HEALTH PROVIDERS

Special Expertise: Serious

Mental Illness

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Yacoub, Ehab MD

14541 Delano St

Van Nuys, CA 91411

(310) 515-8113

License: A76244

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: M-F 9AM-5PM, SA

7AM-2PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, IB, E;

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: Serious

Mental Illness

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

WEST COVINA

91790

Garg, Bimlesh MD

1535 W Merced Ave Ste 300

West Covina, CA 91790

(626) 962-8451

License: 41524

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Other Language: Hindi,

Panjabi, Punjabi

Cultural Competency: NR

Accessibility: P, IB, R; 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: Physical

Disabilities, HIV/AIDS, Serious

Mental Illness, Co-occuring

Disorders

UPDATE: NEW Provider Added.

Effective_Date: 01-AUG-13

WILMINGTON

90744

St. Mary, Gordon PSY

1029 W Pacific Coast Hwy

Wilmington, CA 90744

(818) 326-3816

License: 17475

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: M-F 9AM-7PM

PTA: No

Cultural Competency: NR

Accessibility: P, EB, IB, E, R;

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: Physical

Disabilities, Serious Mental

Illness, Deafness or

Hard-of-Hearing, Co-occuring

Disorders

UPDATE: NEW Provider Added.

Effective_Date: 01-AUG-13

WOODLAND HILLS

91364

Bavarsky, Anita PSY

23123 Ventura Blvd Ste 210

Woodland Hills, CA 91364

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

252

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LOS ANGELES COUNTY MENTAL HEALTH PROVIDERS

(818) 340-4999 provider’s office to discuss

License: 22481 their accessibility needs.

Credentials and/or board Special Expertise: Serious

certification: Not Applicable Mental Illness

Accepting New Members: Yes UPDATE: There was a change

Hours: Contact facility for in the provider record;

hours of operation demographic, phone and/or

PTA: No panel status.

Other Language: Hebrew,

Russian

Cultural Competency: NR

Members should call the

provider’s office to discuss

their accessibility needs.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Booth, Thomas CSW

4869 Topanga Canyon Blvd

Ste 1

Woodland Hills, CA 91364

(818) 925-5528

License: 74254

Credentials and/or board

certification: Not Applicable

Accepting New Members: Yes

Hours: M,SA 8AM-9PM, TU-F

7PM-9PM

PTA: No

Cultural Competency: NR

Members should call the

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

253

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LOS ANGELES COUNTY VISION PROVIDERS

ALHAMBRA

91801

Hong, Donna OD

2 W Main St

Alhambra, CA 91801

(626) 282-3115

License: 13249

Accepting New Members: Yes

Hours: TU,F 10AM-6PM, W

10AM-6:30PM, TH 10AM-5PM

PTA: Yes

Other Language: Spanish,

Vietnamese

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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: 07-FEB-20

ARCADIA

91007

Chang, Tom MD

301 W Huntington Dr Ste 107

Arcadia, CA 91007

(626) 574-0188

License: A69909

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: Yes

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Kim, Melody OD

301 W Huntington Dr Ste 107

Arcadia, CA 91007

(626) 574-0188

License: 14726

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: Yes

Other Language: Korean,

Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Wainess, Reid MD

301 W Huntington Dr Ste 107

Arcadia, CA 91007

(626) 574-0188

License: A108766

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: Yes

Other Language: Hebrew,

Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

ARTESIA

90701

Chang, Michael OD

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

254

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LOS ANGELES COUNTY VISION PROVIDERS

17801 Pioneer Blvd Ste F their accessibility needs when Johnson, Jeany OD

Artesia, CA 90701 there is limited access or when 19038 Norwalk Blvd

(562) 467-0813 accessibility indicators are not Artesia, CA 90701

License: 11341 present. (562) 653-9500

Accepting New Members: Yes UPDATE: There was a change License: 33670

Hours: M-SU 10AM-7PM in the provider record; Accepting New Members: Yes

PTA: No demographic, phone and/or Hours: M-F 9AM-6PM

Other Language: Chinese panel status. PTA: No

Cultural Competency: CC Other Language: Korean

Accessibility: P, EB, IB, E, R; Cultural Competency: CC

Members should call the Hsu, Grace OD Accessibility: P, EB, IB, E, R;

provider’s office to discuss 17801 Pioneer Blvd Ste F Members should call the

their accessibility needs when Artesia, CA 90701 provider’s office to discuss

there is limited access or when (562) 467-0813 their accessibility needs when

accessibility indicators are not License: 15097 there is limited access or when

present. Accepting New Members: Yes accessibility indicators are not

UPDATE: There was a change Hours: M-SU 10AM-7PM present.

in the provider record; PTA: No UPDATE: There was a change

demographic, phone and/or Other Language: Portuguese, in the provider record;

panel status. Spanish, Chinese demographic, phone and/or

Cultural Competency: CC panel status.

Accessibility: P, EB, IB, E, R;

Chen, Joyce OD Members should call the

17801 Pioneer Blvd Ste F provider’s office to discuss Lee, Joseph MD

Artesia, CA 90701 their accessibility needs when 19038 Norwalk Blvd

(562) 467-0813 there is limited access or when Artesia, CA 90701

License: 13953 accessibility indicators are not (562) 653-9500

Accepting New Members: Yes present. License: A60445

Hours: M-SU 10AM-7PM UPDATE: There was a change Accepting New Members: Yes

PTA: No in the provider record; Hours: M-F 9AM-6PM

Cultural Competency: CC demographic, phone and/or PTA: No

Accessibility: P, EB, IB, E, R; panel status. Other Language: Japanese,

Members should call the Korean, Spanish, Vietnamese

provider’s office to discuss Cultural Competency: CC

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

255

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LOS ANGELES COUNTY VISION PROVIDERS

Accessibility: P, EB, IB, E, R;

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.

Ly, Richard OD

17801 Pioneer Blvd Ste F

Artesia, CA 90701

(562) 467-0813

License: 34078

Accepting New Members: Yes

Hours: M-SU 10AM-7PM

PTA: No

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Tran, Helen OD

17801 Pioneer Blvd Ste F

Artesia, CA 90701

(562) 467-0813

License: 33583

Accepting New Members: Yes

Hours: M-SU 10AM-7PM

PTA: No

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Yim, Irene OD

19038 Norwalk Blvd

Artesia, CA 90701

(562) 653-9500

License: 9722

Accepting New Members: Yes

Hours: M-F 9AM-6PM

PTA: No

Other Language: Korean,

Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

BELLFLOWER

90706

Green, Eugene OD

9838 Flower St

Bellflower, CA 90706

(562) 920-1915

License: 7673

Accepting New Members: Yes

Hours: M,W 10AM-5PM

PTA: Yes

Other Language: Spanish,

Tagalog

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

256

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LOS ANGELES COUNTY VISION PROVIDERS

in the provider record;

demographic, phone and/or

panel status.

Latter, Mitchell MD

10230 Artesia Blvd Ste 204

Bellflower, CA 90706

(562) 920-8829

License: G40013

Accepting New Members: Yes

Hours: M-F 9AM-5PM

PTA: No

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

CITY OF INDUSTRY

91748

Chang, Tom MD

17833 Colima Rd

City Of Industry, CA 91748

(626) 965-8895

License: A69909

Accepting New Members: Yes

Hours: TU-F 9AM-5PM, SA

9AM-2PM

PTA: No

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Chen, Brian MD

17833 Colima Rd

City Of Industry, CA 91748

(626) 965-8895

License: A127719

Accepting New Members: Yes

Hours: TU-F 9AM-5PM, SA

9AM-2PM

PTA: No

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Tran, Henry OD

17833 Colima Rd

City Of Industry, CA 91748

(626) 965-8895

License: 15159

Accepting New Members: Yes

Hours: TU-F 9AM-5PM, SA

9AM-2PM

PTA: No

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Wainess, Reid MD

17833 Colima Rd

City Of Industry, CA 91748

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

257

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LOS ANGELES COUNTY VISION PROVIDERS

(626) 965-8895

License: A108766

Accepting New Members: Yes

Hours: TU-F 9AM-5PM, SA

9AM-2PM

PTA: No

Other Language: Hebrew,

Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

DOWNEY

90240

Okie, Theodore MD

8409 Florence Ave Ste 100

Downey, CA 90240

(562) 862-4444

License: G8937

Accepting New Members: Yes

Hours: M-TH 9AM-5PM, F

8AM-1PM

PTA: No

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Peters, Joseph MD

8409 Florence Ave Ste 100

Downey, CA 90240

(562) 862-4444

License: G30203

Accepting New Members: Yes

Hours: M-TH 9AM-5PM, F

8AM-1PM

PTA: No

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Shammas, Hanna MD

8409 Florence Ave Ste 100

Downey, CA 90240

(562) 862-4444

License: A30800

Accepting New Members: Yes

Hours: M-TH 9AM-5PM, F

8AM-1PM

PTA: No

Other Language: Arabic,

French

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Swearingen, Michael OD

8409 Florence Ave Ste 100

Downey, CA 90240

(562) 862-4444

License: 5603

Accepting New Members: Yes

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

258

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LOS ANGELES COUNTY VISION PROVIDERS

Hours: M-TH 9AM-5PM, F

8AM-1PM

PTA: No

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

90241

Edelstein, Arthur MD

11411 Brookshire Ave Ste 506

Downey, CA 90241

(562) 923-6256

License: G18506

Accepting New Members: Yes

Hours: M-F 9AM-6PM

PTA: No

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

GLENDALE

91202

Amini, Payam MD

1025 N Brand Blvd Ste 200

Glendale, CA 91202

(818) 583-9933

License: A107595

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: No

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Moore, Lori MD

1025 N Brand Blvd Ste 200

Glendale, CA 91202

(818) 583-9933

License: G57630

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Patel, Jay MD

1025 N Brand Blvd Ste 200

Glendale, CA 91202

(818) 583-9933

License: A127433

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: No

Other Language: Gujarati,

Hindi, Polish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

Members should call the

provider’s office to discuss

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

259

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LOS ANGELES COUNTY VISION PROVIDERS

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.

Shaw, Minh OD

1025 N Brand Blvd Ste 200

Glendale, CA 91202

(818) 583-9933

License: 13540

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: No

Other Language: Vietnamese

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Shelton, Raymond MD

1025 N Brand Blvd Ste 200

Glendale, CA 91202

(818) 583-9933

License: G60028

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Villegas, Rex OD

1025 N Brand Blvd Ste 200

Glendale, CA 91202

(818) 583-9933

License: 12668

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: No

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

91203

Baghoumian, Marineh OD

435 Arden Ave Ste 430

Glendale, CA 91203

(818) 539-8016

License: 14842

Accepting New Members: Yes

Hours: M-F 8AM-4:30PM

PTA: No

Other Language: Armenian

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

260

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LOS ANGELES COUNTY VISION PROVIDERS

Chang, Tom MD

435 Arden Ave Ste 430

Glendale, CA 91203

(818) 539-8016

License: A69909

Accepting New Members: Yes

Hours: M-F 8AM-4:30PM

PTA: No

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Kim, Melody OD

435 Arden Ave Ste 430

Glendale, CA 91203

(818) 539-8016

License: 14726

Accepting New Members: Yes

Hours: M-F 8AM-4:30PM

PTA: No

Other Language: Korean,

Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Malek, Renia OD

435 Arden Ave Ste 430

Glendale, CA 91203

(818) 539-8016

License: 33840

Accepting New Members: Yes

Hours: M-F 8AM-4:30PM

PTA: No

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

GLENDORA

91741

Amini, Payam MD

150 S Grand Ave Ste I

Glendora, CA 91741

(626) 335-2114

License: A107595

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: Yes

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Cairnie, Mary OD

150 S Grand Ave Ste I

Glendora, CA 91741

(626) 335-2114

License: 33545

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: Yes

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

261

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LOS ANGELES COUNTY VISION PROVIDERS

Members should call the Diggory, Matthew OD provider’s office to discuss

provider’s office to discuss 150 S Grand Ave Ste I their accessibility needs when

their accessibility needs when Glendora, CA 91741 there is limited access or when

there is limited access or when (626) 335-2114 accessibility indicators are not

accessibility indicators are not License: 33521 present.

present. Accepting New Members: Yes UPDATE: There was a change

UPDATE: There was a change Hours: M-F 8AM-5PM in the provider record;

in the provider record; PTA: Yes demographic, phone and/or

demographic, phone and/or Cultural Competency: CC panel status.

panel status. Accessibility: P, EB, IB, E, R;

Members should call the

provider’s office to discuss Huang, Jeffrey DO

Chu, Selena OD their accessibility needs when 150 S Grand Ave Ste I

150 S Grand Ave Ste I there is limited access or when Glendora, CA 91741

Glendora, CA 91741 accessibility indicators are not (626) 335-2114

(626) 335-2114 present. License: 20A11984

License: 33549 UPDATE: There was a change Accepting New Members: Yes

Accepting New Members: Yes in the provider record; Hours: M-F 8AM-5PM

Hours: M-F 8AM-5PM demographic, phone and/or PTA: Yes

PTA: Yes panel status. Other Language: Chinese

Cultural Competency: CC Cultural Competency: CC

Accessibility: P, EB, IB, E, R; Accessibility: P, EB, IB, E, R;

Members should call the Duan, Deborah OD Members should call the

provider’s office to discuss 150 S Grand Ave Ste I provider’s office to discuss

their accessibility needs when Glendora, CA 91741 their accessibility needs when

there is limited access or when (626) 335-2114 there is limited access or when

accessibility indicators are not License: 34232 accessibility indicators are not

present. Accepting New Members: Yes present.

UPDATE: There was a change Hours: M-F 8AM-5PM UPDATE: There was a change

in the provider record; PTA: Yes in the provider record;

demographic, phone and/or Other Language: Chinese demographic, phone and/or

panel status. Cultural Competency: CC panel status.

Accessibility: P, EB, IB, E, R;

Members should call the

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

262

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LOS ANGELES COUNTY VISION PROVIDERS

Luke, Priscilla MD provider’s office to discuss

150 S Grand Ave Ste I their accessibility needs when Patel, Jay MD

Glendora, CA 91741 there is limited access or when 150 S Grand Ave Ste I

(626) 335-2114 accessibility indicators are not Glendora, CA 91741

License: A107548 present. (626) 335-2114

Accepting New Members: Yes UPDATE: There was a change License: A127433

Hours: M-F 8AM-5PM in the provider record; Accepting New Members: Yes

PTA: Yes demographic, phone and/or Hours: M-F 8AM-5PM

Cultural Competency: CC panel status. PTA: Yes

Accessibility: P, EB, IB, E, R; Other Language: Gujarati,

Members should call the Hindi, Polish

provider’s office to discuss Ong, Olivia MD Cultural Competency: CC

their accessibility needs when 150 S Grand Ave Ste I Accessibility: P, EB, IB, E, R;

there is limited access or when Glendora, CA 91741 Members should call the

accessibility indicators are not (626) 335-2114 provider’s office to discuss

present. License: A66933 their accessibility needs when

UPDATE: There was a change Accepting New Members: Yes there is limited access or when

in the provider record; Hours: M-F 8AM-5PM accessibility indicators are not

demographic, phone and/or PTA: Yes present.

panel status. Other Language: Burmese, UPDATE: There was a change

Spanish in the provider record;

Cultural Competency: CC demographic, phone and/or

Ochoa, Araceli OD Accessibility: P, EB, IB, E, R; panel status.

150 S Grand Ave Ste I Members should call the

Glendora, CA 91741 provider’s office to discuss

(626) 335-2114 their accessibility needs when Rezaei Abbassi, Nima MD

License: 33514 there is limited access or when 150 S Grand Ave Ste I

Accepting New Members: Yes accessibility indicators are not Glendora, CA 91741

Hours: M-F 8AM-5PM present. (626) 335-2114

PTA: Yes UPDATE: There was a change License: A131669

Other Language: Spanish in the provider record; Accepting New Members: Yes

Cultural Competency: CC demographic, phone and/or Hours: M-F 8AM-5PM

Accessibility: P, EB, IB, E, R; panel status. PTA: Yes

Members should call the Cultural Competency: CC

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

263

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LOS ANGELES COUNTY VISION PROVIDERS

Accessibility: P, EB, IB, E, R;

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.

Shaw, Minh OD

150 S Grand Ave Ste I

Glendora, CA 91741

(626) 335-2114

License: 13540

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: Yes

Other Language: Vietnamese

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Tran, Jennie OD

150 S Grand Ave Ste I

Glendora, CA 91741

(626) 335-2114

License: 14276

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: Yes

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Villegas, Rex OD

150 S Grand Ave Ste I

Glendora, CA 91741

(626) 335-2114

License: 12668

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: Yes

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

HOLLYWOOD

90028

Ordonez, Xavier OD

6464 W Sunset Blvd Ste 110

Hollywood, CA 90028

(323) 469-3131

License: 11089

Accepting New Members: Yes

Hours: TU-F 10AM-6PM, SA

9AM-3PM

PTA: Yes

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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;

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

264

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LOS ANGELES COUNTY VISION PROVIDERS

demographic, phone and/or

panel status.

HUNTINGTON PARK

90255

Arredondo, Alex OD

2675 Saturn Ave

Huntington Park, CA 90255

(323) 583-7900

License: 8658

Accepting New Members: Yes

Hours: M-F 9:30AM-6PM, SA

9AM-3PM

PTA: No

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

De La Pena, William MD

2715 E Florence Ave

Huntington Park, CA 90255

(323) 581-0120

License: A31272

Accepting New Members: Yes

Hours: M-F 9AM-6PM, SA

8AM-4PM

PTA: No

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Dominguez, Charles OD

2715 E Florence Ave

Huntington Park, CA 90255

(323) 581-0120

License: 12292

Accepting New Members: Yes

Hours: M-F 9AM-6PM, SA

8AM-4PM

PTA: No

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Garcia, Eddie MD

2715 E Florence Ave

Huntington Park, CA 90255

(323) 581-0120

License: G53767

Accepting New Members: Yes

Hours: M-F 9AM-6PM, SA

8AM-4PM

PTA: No

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

265

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LOS ANGELES COUNTY VISION PROVIDERS

Mandel, Benjamin MD

2715 E Florence Ave

Huntington Park, CA 90255

(323) 581-0120

License: A127151

Accepting New Members: Yes

Hours: M-F 9AM-6PM, SA

8AM-4PM

PTA: No

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Mayberry, Melissa MD

2715 E Florence Ave

Huntington Park, CA 90255

(323) 581-0120

License: A71074

Accepting New Members: Yes

Hours: M-F 9AM-6PM, SA

8AM-4PM

PTA: No

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Mishima, Todd OD

2715 E Florence Ave

Huntington Park, CA 90255

(323) 581-0120

License: 9700

Accepting New Members: Yes

Hours: M-F 9AM-6PM, SA

8AM-4PM

PTA: No

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Moayedpardazi, Hamideh MD

2715 E Florence Ave

Huntington Park, CA 90255

(323) 581-0120

License: A137200

Accepting New Members: Yes

Hours: M-F 9AM-6PM, SA

8AM-4PM

PTA: No

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Nguyen, Meggie OD

2715 E Florence Ave

Huntington Park, CA 90255

(323) 581-0120

License: 15342

Accepting New Members: Yes

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

266

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LOS ANGELES COUNTY VISION PROVIDERS

Hours: M-F 9AM-6PM, SA accessibility indicators are not Huntington Park, CA 90255

8AM-4PM present. (323) 581-0120

PTA: No UPDATE: There was a change License: A71222

Cultural Competency: CC in the provider record; Accepting New Members: Yes

Accessibility: P, EB, IB, E, R; demographic, phone and/or Hours: M-F 9AM-6PM, SA

Members should call the panel status. 8AM-4PM

provider’s office to discuss PTA: No

their accessibility needs when Other Language: Spanish

there is limited access or when Perez, Evelyn OD Cultural Competency: CC

accessibility indicators are not 2715 E Florence Ave Accessibility: P, EB, IB, E, R;

present. Huntington Park, CA 90255 Members should call the

UPDATE: There was a change (323) 581-0120 provider’s office to discuss

in the provider record; License: 10155 their accessibility needs when

demographic, phone and/or Accepting New Members: Yes there is limited access or when

panel status. Hours: M-F 9AM-6PM, SA accessibility indicators are not

8AM-4PM present.

PTA: No UPDATE: There was a change

Nguyen, Thien Thu OD Other Language: Spanish in the provider record;

2715 E Florence Ave Cultural Competency: CC demographic, phone and/or

Huntington Park, CA 90255 Accessibility: P, EB, IB, E, R; panel status.

(323) 581-0120 Members should call the

License: 13098 provider’s office to discuss

Accepting New Members: Yes their accessibility needs when Sanchez, Adriana OD

Hours: M-F 9AM-6PM, SA there is limited access or when 2715 E Florence Ave

8AM-4PM accessibility indicators are not Huntington Park, CA 90255

PTA: No present. (323) 581-0120

Other Language: Spanish, UPDATE: There was a change License: 14769

Vietnamese in the provider record; Accepting New Members: Yes

Cultural Competency: CC demographic, phone and/or Hours: M-F 9AM-6PM, SA

Accessibility: P, EB, IB, E, R; panel status. 8AM-4PM

Members should call the PTA: No

provider’s office to discuss Other Language: Spanish

their accessibility needs when Salib, George MD Cultural Competency: CC

there is limited access or when 2715 E Florence Ave Accessibility: P, EB, IB, E, R;

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

267

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LOS ANGELES COUNTY VISION PROVIDERS

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.

Uchio, Alejandra MD

2715 E Florence Ave

Huntington Park, CA 90255

(323) 581-0120

License: A78760

Accepting New Members: Yes

Hours: M-F 9AM-6PM, SA

8AM-4PM

PTA: No

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Ung, Susan OD

2715 E Florence Ave

Huntington Park, CA 90255

(323) 581-0120

License: 12206

Accepting New Members: Yes

Hours: M-F 9AM-6PM, SA

8AM-4PM

PTA: No

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

LAKEWOOD

90712

Gottlieb, Larry OD

322 Lakewood Center Mall

Lakewood, CA 90712

(562) 630-2020

License: 6451

Accepting New Members: Yes

Hours: SU 11AM-6PM, M-F

10AM-7PM, SA 10AM-6PM

PTA: No

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

90713

Gottlieb, Larry OD

6418 Del Amo Blvd

Lakewood, CA 90713

(562) 420-2055

License: 6451

Accepting New Members: Yes

Hours: M-TH 10AM-7PM, F

10AM-6PM, SA 9AM-2PM

PTA: Yes

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

Members should call the

provider’s office to discuss

their accessibility needs when

there is limited access or when

accessibility indicators are not

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

268

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LOS ANGELES COUNTY VISION PROVIDERS

present.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

LANCASTER

93534

Alasil, Tarek MD

44815 Fig Ave

Lancaster, CA 93534

(661) 206-9753

License: A108797

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: Yes

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Baghoumian, Marineh OD

44815 Fig Ave

Lancaster, CA 93534

(661) 206-9753

License: 14842

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: Yes

Other Language: Armenian

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Chang, Tom MD

44815 Fig Ave

Lancaster, CA 93534

(661) 206-9753

License: A69909

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: Yes

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Chen, Brian MD

44815 Fig Ave

Lancaster, CA 93534

(661) 206-9753

License: A127719

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Culotta, Anthony MD

44815 Fig Ave

Lancaster, CA 93534

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

269

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LOS ANGELES COUNTY VISION PROVIDERS

(661) 206-9753

License: A97142

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: Yes

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Malek, Renia OD

44815 Fig Ave

Lancaster, CA 93534

(661) 206-9753

License: 33840

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: Yes

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Tran, Henry OD

44815 Fig Ave

Lancaster, CA 93534

(661) 206-9753

License: 15159

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: Yes

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Wainess, Reid MD

44815 Fig Ave

Lancaster, CA 93534

(661) 206-9753

License: A108766

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: Yes

Other Language: Hebrew,

Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

LONG BEACH

90807

Chang, Michael OD

4700 Cherry Ave

Long Beach, CA 90807

(562) 980-0325

License: 11341

Accepting New Members: Yes

Hours: M-SA 10AM-7PM

PTA: No

Other Language: Chinese

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

Members should call the

provider’s office to discuss

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

270

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LOS ANGELES COUNTY VISION PROVIDERS

their accessibility needs when Goldstone, Harvey OD Accessibility: P, EB, IB, E, R;

there is limited access or when 2280 E Carson St Members should call the

accessibility indicators are not Long Beach, CA 90807 provider’s office to discuss

present. (562) 422-2020 their accessibility needs when

UPDATE: There was a change License: 5273 there is limited access or when

in the provider record; Accepting New Members: Yes accessibility indicators are not

demographic, phone and/or Hours: M-F 9AM-6PM, SA present.

panel status. 9AM-4PM UPDATE: There was a change

PTA: Yes in the provider record;

Other Language: Spanish demographic, phone and/or

Goldstone, Alan OD Cultural Competency: CC panel status.

2280 E Carson St Accessibility: P, EB, IB, E, R;

Long Beach, CA 90807 Members should call the

(562) 422-2020 provider’s office to discuss Ly, Richard OD

License: 12297 their accessibility needs when 4700 Cherry Ave

Accepting New Members: Yes there is limited access or when Long Beach, CA 90807

Hours: M-F 9AM-6PM, SA accessibility indicators are not (562) 980-0325

9AM-4PM present. License: 34078

PTA: Yes UPDATE: There was a change Accepting New Members: Yes

Other Language: Spanish in the provider record; Hours: M-SA 10AM-7PM

Cultural Competency: CC demographic, phone and/or PTA: No

Accessibility: P, EB, IB, E, R; panel status. Cultural Competency: CC

Members should call the Accessibility: P, EB, IB, E, R;

provider’s office to discuss Members should call the

their accessibility needs when Huang, Catherine OD provider’s office to discuss

there is limited access or when 2280 E Carson St their accessibility needs when

accessibility indicators are not Long Beach, CA 90807 there is limited access or when

present. (562) 422-2020 accessibility indicators are not

UPDATE: There was a change License: 33509 present.

in the provider record; Accepting New Members: Yes UPDATE: There was a change

demographic, phone and/or Hours: M-F 9AM-6PM, SA in the provider record;

panel status. 9AM-4PM demographic, phone and/or

PTA: Yes panel status.

Cultural Competency: CC

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

271

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LOS ANGELES COUNTY VISION PROVIDERS

Nguyen, Thy OD

2280 E Carson St

Long Beach, CA 90807

(562) 422-2020

License: 12746

Accepting New Members: Yes

Hours: M-F 9AM-6PM, SA

9AM-4PM

PTA: Yes

Other Language: Spanish,

Vietnamese

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

90808

Alasil, Tarek MD

3816 Woodruff Ave Ste 100

Long Beach, CA 90808

(562) 424-0931

License: A108797

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: No

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Bei, Ling MD

3816 Woodruff Ave Ste 100

Long Beach, CA 90808

(562) 424-0931

License: A129618

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: No

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Boeckmann, Jessica MD

3816 Woodruff Ave Ste 100

Long Beach, CA 90808

(562) 424-0931

License: A124361

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: No

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Chang, Tom MD

3816 Woodruff Ave Ste 100

Long Beach, CA 90808

(562) 424-0931

License: A69909

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: No

Cultural Competency: CC

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

272

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LOS ANGELES COUNTY VISION PROVIDERS

Accessibility: P, EB, IB, E, R; Members should call the

Members should call the provider’s office to discuss

provider’s office to discuss Chew, Wesley OD their accessibility needs when

their accessibility needs when 3816 Woodruff Ave Ste 100 there is limited access or when

there is limited access or when Long Beach, CA 90808 accessibility indicators are not

accessibility indicators are not (562) 424-0931 present.

present. License: 14901 UPDATE: There was a change

UPDATE: There was a change Accepting New Members: Yes in the provider record;

in the provider record; Hours: M-F 8AM-5PM demographic, phone and/or

demographic, phone and/or PTA: No panel status.

panel status. Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

Members should call the Grant-acquah, Kweku MD

Chen, Brian MD provider’s office to discuss 3816 Woodruff Ave Ste 100

3816 Woodruff Ave Ste 100 their accessibility needs when Long Beach, CA 90808

Long Beach, CA 90808 there is limited access or when (562) 424-0931

(562) 424-0931 accessibility indicators are not License: A126202

License: A127719 present. Accepting New Members: Yes

Accepting New Members: Yes UPDATE: There was a change Hours: M-F 8AM-5PM

Hours: M-F 8AM-5PM in the provider record; PTA: No

PTA: No demographic, phone and/or Cultural Competency: CC

Other Language: Spanish panel status. Accessibility: P, EB, IB, E, R;

Cultural Competency: CC Members should call the

Accessibility: P, EB, IB, E, R; provider’s office to discuss

Members should call the Culotta, Anthony MD their accessibility needs when

provider’s office to discuss 3816 Woodruff Ave Ste 100 there is limited access or when

their accessibility needs when Long Beach, CA 90808 accessibility indicators are not

there is limited access or when (562) 424-0931 present.

accessibility indicators are not License: A97142 UPDATE: There was a change

present. Accepting New Members: Yes in the provider record;

UPDATE: There was a change Hours: M-F 8AM-5PM demographic, phone and/or

in the provider record; PTA: No panel status.

demographic, phone and/or Cultural Competency: CC

panel status. Accessibility: P, EB, IB, E, R;

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

273

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LOS ANGELES COUNTY VISION PROVIDERS

Quach, Phuc OD

3816 Woodruff Ave Ste 100

Long Beach, CA 90808

(562) 424-0931

License: 12891

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: No

Other Language: Spanish,

Vietnamese

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Renner, Morgan MD

3816 Woodruff Ave Ste 100

Long Beach, CA 90808

(562) 424-0931

License: A142841

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Rose, Michael MD

3816 Woodruff Ave Ste 100

Long Beach, CA 90808

(562) 424-0931

License: G33914

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: No

Other Language: Spanish,

Vietnamese, Chinese

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Wainess, Reid MD

3816 Woodruff Ave Ste 100

Long Beach, CA 90808

(562) 424-0931

License: A108766

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: No

Other Language: Hebrew,

Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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

90006

Green, Eugene OD

1818 S Western Ave Ste 101

Los Angeles, CA 90006

(323) 731-2474

License: 7673

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

274

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LOS ANGELES COUNTY VISION PROVIDERS

Accepting New Members: Yes

Hours: TU,F 10AM-5PM

PTA: No

Other Language: Spanish,

Tagalog

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

90012

Tom, Wesley OD

942 N Broadway Ste 104

Los Angeles, CA 90012

(213) 680-9393

License: 9469

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Other Language: Spanish,

Chinese

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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: TERMED Provider.

Effective Date: 31-JAN-20

Yu, Elaine OD

200 S San Pedro St Ste B

Los Angeles, CA 90012

(213) 617-2020

License: 34447

Accepting New Members: Yes

Hours: M,W,F,SA 9AM-5PM,

TU,TH 9AM-6PM

PTA: Yes

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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: 10-JAN-20

90015

Eng, Calvin MD

1120 W Washington Blvd

Los Angeles, CA 90015

(213) 623-2225

License: G55239

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: No

Other Language: Spanish,

Vietnamese, Chinese

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

90016

Tom, Wesley OD

2825 Crenshaw Blvd Ste A

Los Angeles, CA 90016

(323) 373-9633

License: 9469

Accepting New Members: Yes

Hours: M-SA 10AM-5:30PM

PTA: Yes

Other Language: Spanish,

Chinese

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

275

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LOS ANGELES COUNTY VISION PROVIDERS

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.

90017

Chang, Tom MD

1127 Wilshire Blvd Ste 504

Los Angeles, CA 90017

(213) 413-7301

License: A69909

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: Yes

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Grant-acquah, Kweku MD

1127 Wilshire Blvd Ste 504

Los Angeles, CA 90017

(213) 413-7301

License: A126202

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: Yes

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Kim, Melody OD

1127 Wilshire Blvd Ste 504

Los Angeles, CA 90017

(213) 413-7301

License: 14726

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: Yes

Other Language: Korean,

Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Wainess, Reid MD

1127 Wilshire Blvd Ste 504

Los Angeles, CA 90017

(213) 413-7301

License: A108766

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: Yes

Other Language: Hebrew,

Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

276

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LOS ANGELES COUNTY VISION PROVIDERS

panel status. PTA: Yes present.

90020

Johnson, Jeany OD

505 S Virgil Ave Ste 300

Los Angeles, CA 90020

(213) 384-5222

License: 33670

Accepting New Members: Yes

Hours: M-W,F,SA 9AM-5PM

PTA: Yes

Other Language: Korean

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Lee, Joseph MD

505 S Virgil Ave Ste 300

Los Angeles, CA 90020

(213) 384-5222

License: A60445

Accepting New Members: Yes

Hours: M-W,F,SA 9AM-5PM

Other Language: Japanese,

Korean, Spanish, Vietnamese

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Yim, Irene OD

505 S Virgil Ave Ste 300

Los Angeles, CA 90020

(213) 384-5222

License: 9722

Accepting New Members: Yes

Hours: M-W,F,SA 9AM-5PM

PTA: Yes

Other Language: Korean,

Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

Members should call the

provider’s office to discuss

their accessibility needs when

there is limited access or when

accessibility indicators are not

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

90023

Allen, Daniel OD

3350 Whittier Blvd

Los Angeles, CA 90023

(323) 268-1131

License: 15103

Accepting New Members: Yes

Hours: M-F 10AM-5:30PM, SA

10AM-2PM

PTA: No

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Perez, Luis OD

3350 Whittier Blvd

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

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LOS ANGELES COUNTY VISION PROVIDERS

Los Angeles, CA 90023

(323) 268-1131

License: 12750

Accepting New Members: Yes

Hours: M-F 10AM-5:30PM, SA

10AM-2PM

PTA: No

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

90026

Allen, Daniel OD

1509 W Sunset Blvd

Los Angeles, CA 90026

(213) 250-5768

License: 15103

Accepting New Members: Yes

Hours: M-F 9AM-5:30PM, SA

9AM-12PM

PTA: No

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Chang, Bogard OD

1711 W Temple St Ste 7135

Los Angeles, CA 90026

(213) 413-8213

License: 11253

Accepting New Members: Yes

Hours: M-TH 9AM-6PM, F

9AM-5PM

PTA: No

Other Language: Chinese

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Perez, Luis OD

1509 W Sunset Blvd

Los Angeles, CA 90026

(213) 250-5768

License: 12750

Accepting New Members: Yes

Hours: M-F 9AM-5:30PM, SA

9AM-12PM

PTA: No

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

90031

Chang, Tom MD

2400 N Broadway

Los Angeles, CA 90031

(323) 221-8000

License: A69909

Accepting New Members: Yes

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

278

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LOS ANGELES COUNTY VISION PROVIDERS

Hours: M-F 8:30AM-5:30PM

PTA: No

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Chen, Brian MD

2400 N Broadway

Los Angeles, CA 90031

(323) 221-8000

License: A127719

Accepting New Members: Yes

Hours: M-F 8:30AM-5:30PM

PTA: No

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Davis, Michael MD

2400 N Broadway

Los Angeles, CA 90031

(323) 221-8000

License: A111866

Accepting New Members: Yes

Hours: M-F 8:30AM-5:30PM

PTA: No

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Du, Elizabeth MD

2400 N Broadway

Los Angeles, CA 90031

(323) 221-8000

License: C142813

Accepting New Members: Yes

Hours: M-F 8:30AM-5:30PM

PTA: No

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Kim, Melody OD

2400 N Broadway

Los Angeles, CA 90031

(323) 221-8000

License: 14726

Accepting New Members: Yes

Hours: M-F 8:30AM-5:30PM

PTA: No

Other Language: Korean,

Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

279

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LOS ANGELES COUNTY VISION PROVIDERS

in the provider record;

demographic, phone and/or

panel status.

Rose, Michael MD

2400 N Broadway

Los Angeles, CA 90031

(323) 221-8000

License: G33914

Accepting New Members: Yes

Hours: M-F 8:30AM-5:30PM

PTA: No

Other Language: Spanish,

Vietnamese, Chinese

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Tran, Henry OD

2400 N Broadway

Los Angeles, CA 90031

(323) 221-8000

License: 15159

Accepting New Members: Yes

Hours: M-F 8:30AM-5:30PM

PTA: No

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Wainess, Reid MD

2400 N Broadway

Los Angeles, CA 90031

(323) 221-8000

License: A108766

Accepting New Members: Yes

Hours: M-F 8:30AM-5:30PM

PTA: No

Other Language: Hebrew,

Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

90045

Chang, Tom MD

8616 La Tijera Blvd Ste 102

Los Angeles, CA 90045

(310) 673-2020

License: A69909

Accepting New Members: Yes

Hours: M-F 8AM-4:30PM

PTA: No

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Culotta, Anthony MD

8616 La Tijera Blvd Ste 102

Los Angeles, CA 90045

(310) 673-2020

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

280

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LOS ANGELES COUNTY VISION PROVIDERS

License: A97142 accessibility indicators are not License: 12891

Accepting New Members: Yes present. Accepting New Members: Yes

Hours: M-F 8AM-4:30PM UPDATE: There was a change Hours: M-F 8AM-4:30PM

PTA: No in the provider record; PTA: No

Cultural Competency: CC demographic, phone and/or Other Language: Spanish,

Accessibility: P, EB, IB, E, R; panel status. Vietnamese

Members should call the Cultural Competency: CC

provider’s office to discuss Accessibility: P, EB, IB, E, R;

their accessibility needs when Grant-acquah, Kweku MD Members should call the

there is limited access or when 8616 La Tijera Blvd Ste 102 provider’s office to discuss

accessibility indicators are not Los Angeles, CA 90045 their accessibility needs when

present. (310) 673-2020 there is limited access or when

UPDATE: There was a change License: A126202 accessibility indicators are not

in the provider record; Accepting New Members: Yes present.

demographic, phone and/or Hours: M-F 8AM-4:30PM UPDATE: There was a change

panel status. PTA: No in the provider record;

Cultural Competency: CC demographic, phone and/or

Accessibility: P, EB, IB, E, R; panel status.

Goodwin Jr, Lawrence MD Members should call the

8717 La Tijera Blvd provider’s office to discuss

Los Angeles, CA 90045 their accessibility needs when Rose, Michael MD

(310) 674-2895 there is limited access or when 8616 La Tijera Blvd Ste 102

License: C40581 accessibility indicators are not Los Angeles, CA 90045

Accepting New Members: Yes present. (310) 673-2020

Hours: M,W,TH 9AM-5PM, TU,F UPDATE: There was a change License: G33914

9AM-1PM in the provider record; Accepting New Members: Yes

PTA: No demographic, phone and/or Hours: M-F 8AM-4:30PM

Other Language: Spanish panel status. PTA: No

Cultural Competency: CC Other Language: Spanish,

Accessibility: P, EB, IB, E, R; Vietnamese, Chinese

Members should call the Quach, Phuc OD Cultural Competency: CC

provider’s office to discuss 8616 La Tijera Blvd Ste 102 Accessibility: P, EB, IB, E, R;

their accessibility needs when Los Angeles, CA 90045 Members should call the

there is limited access or when (310) 673-2020 provider’s office to discuss

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

281

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LOS ANGELES COUNTY VISION PROVIDERS

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.

Wainess, Reid MD

8616 La Tijera Blvd Ste 102

Los Angeles, CA 90045

(310) 673-2020

License: A108766

Accepting New Members: Yes

Hours: M-F 8AM-4:30PM

PTA: No

Other Language: Hebrew,

Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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

Steinschriber, Steven MD

201 S Alvarado St Ste 500

Los Angeles, CA 90057

(213) 413-7301

License: G56229

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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-MAR-09

90058

Mohebbi, Ali OD

4433 S Alameda St Ste C12

Los Angeles, CA 90058

(323) 988-1033

License: 11257

Accepting New Members: Yes

Hours: M,W-SU 10AM-5PM

PTA: No

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

LYNWOOD

90262

Edelstein, Arthur MD

3737 Mlk Jr Blvd Ste 340

Lynwood, CA 90262

(310) 638-0402

License: G18506

Accepting New Members: Yes

Hours: M-F 9AM-6PM

PTA: No

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

282

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LOS ANGELES COUNTY VISION PROVIDERS

panel status.

Mohebbi, Ali OD

3150 E Imperial Hwy Ste 202b

Lynwood, CA 90262

(310) 844-7961

License: 11257

Accepting New Members: Yes

Hours: M,TU,TH,SA,SU

10AM-6PM

PTA: Yes

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Okie, Theodore MD

3510 Mlk Jr Blvd

Lynwood, CA 90262

(310) 635-7550

License: G8937

Accepting New Members: Yes

Hours: M-TH 9AM-5PM, F

8AM-1PM

PTA: No

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Peters, Joseph MD

3510 Mlk Jr Blvd

Lynwood, CA 90262

(310) 635-7550

License: G30203

Accepting New Members: Yes

Hours: M-TH 9AM-5PM, F

8AM-1PM

PTA: No

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Shammas, Hanna MD

3510 Mlk Jr Blvd

Lynwood, CA 90262

(310) 635-7550

License: A30800

Accepting New Members: Yes

Hours: M-TH 9AM-5PM, F

8AM-1PM

PTA: No

Other Language: Arabic,

French

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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

Arredondo, Alex OD

4349 Slauson Ave Ste A

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

283

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LOS ANGELES COUNTY VISION PROVIDERS

Maywood, CA 90270

(323) 581-0117

License: 8658

Accepting New Members: Yes

Hours: M-F 9:30AM-6PM, SA

9AM-2PM

PTA: No

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

MONROVIA

91016

Amini, Payam MD

855 W Foothill Blvd

Monrovia, CA 91016

(626) 358-1080

License: A107595

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: No

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Cairnie, Mary OD

855 W Foothill Blvd

Monrovia, CA 91016

(626) 358-1080

License: 33545

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: No

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Chu, Selena OD

855 W Foothill Blvd

Monrovia, CA 91016

(626) 358-1080

License: 33549

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: No

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Diggory, Matthew OD

855 W Foothill Blvd

Monrovia, CA 91016

(626) 358-1080

License: 33521

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: No

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

Members should call the

provider’s office to discuss

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

284

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LOS ANGELES COUNTY VISION PROVIDERS

their accessibility needs when 855 W Foothill Blvd Members should call the

there is limited access or when Monrovia, CA 91016 provider’s office to discuss

accessibility indicators are not (626) 358-1080 their accessibility needs when

present. License: 20A11984 there is limited access or when

UPDATE: There was a change Accepting New Members: Yes accessibility indicators are not

in the provider record; Hours: M-F 8AM-5PM present.

demographic, phone and/or PTA: No UPDATE: TERMED Provider.

panel status. Other Language: Chinese Effective Date: 14-FEB-20

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

Duan, Deborah OD Members should call the Luke, Priscilla MD

855 W Foothill Blvd provider’s office to discuss 855 W Foothill Blvd

Monrovia, CA 91016 their accessibility needs when Monrovia, CA 91016

(626) 358-1080 there is limited access or when (626) 358-1080

License: 34232 accessibility indicators are not License: A107548

Accepting New Members: Yes present. Accepting New Members: Yes

Hours: M-F 8AM-5PM UPDATE: There was a change Hours: M-F 8AM-5PM

PTA: No in the provider record; PTA: No

Other Language: Chinese demographic, phone and/or Cultural Competency: CC

Cultural Competency: CC panel status. Accessibility: P, EB, IB, E, R;

Accessibility: P, EB, IB, E, R; Members should call the

Members should call the provider’s office to discuss

provider’s office to discuss Lin, Esther OD their accessibility needs when

their accessibility needs when 248 W Foothill Blvd there is limited access or when

there is limited access or when Monrovia, CA 91016 accessibility indicators are not

accessibility indicators are not (626) 359-1213 present.

present. License: 33975 UPDATE: There was a change

UPDATE: There was a change Accepting New Members: Yes in the provider record;

in the provider record; Hours: M,SA 10AM-2PM, TU,TH demographic, phone and/or

demographic, phone and/or 9:30AM-7PM, W,F panel status.

panel status. 9:30AM-5:30PM

PTA: No

Cultural Competency: CC Ochoa, Araceli OD

Huang, Jeffrey DO Accessibility: P, EB, IB, E, R; 855 W Foothill Blvd

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

285

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LOS ANGELES COUNTY VISION PROVIDERS

Monrovia, CA 91016 provider’s office to discuss

(626) 358-1080 their accessibility needs when Rezaei Abbassi, Nima MD

License: 33514 there is limited access or when 855 W Foothill Blvd

Accepting New Members: Yes accessibility indicators are not Monrovia, CA 91016

Hours: M-F 8AM-5PM present. (626) 358-1080

PTA: No UPDATE: There was a change License: A131669

Other Language: Spanish in the provider record; Accepting New Members: Yes

Cultural Competency: CC demographic, phone and/or Hours: M-F 8AM-5PM

Accessibility: P, EB, IB, E, R; panel status. PTA: No

Members should call the Cultural Competency: CC

provider’s office to discuss Accessibility: P, EB, IB, E, R;

their accessibility needs when Patel, Jay MD Members should call the

there is limited access or when 855 W Foothill Blvd provider’s office to discuss

accessibility indicators are not Monrovia, CA 91016 their accessibility needs when

present. (626) 358-1080 there is limited access or when

UPDATE: There was a change License: A127433 accessibility indicators are not

in the provider record; Accepting New Members: Yes present.

demographic, phone and/or Hours: M-F 8AM-5PM UPDATE: There was a change

panel status. PTA: No in the provider record;

Other Language: Gujarati, demographic, phone and/or

Hindi, Polish panel status.

Ong, Olivia MD Cultural Competency: CC

855 W Foothill Blvd Accessibility: P, EB, IB, E, R;

Monrovia, CA 91016 Members should call the Shaw, Minh OD

(626) 358-1080 provider’s office to discuss 855 W Foothill Blvd

License: A66933 their accessibility needs when Monrovia, CA 91016

Accepting New Members: Yes there is limited access or when (626) 358-1080

Hours: M-F 8AM-5PM accessibility indicators are not License: 13540

PTA: No present. Accepting New Members: Yes

Other Language: Burmese, UPDATE: There was a change Hours: M-F 8AM-5PM

Spanish in the provider record; PTA: No

Cultural Competency: CC demographic, phone and/or Other Language: Vietnamese

Accessibility: P, EB, IB, E, R; panel status. Cultural Competency: CC

Members should call the Accessibility: P, EB, IB, E, R;

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

286

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LOS ANGELES COUNTY VISION PROVIDERS

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.

Shelton, Raymond MD

855 W Foothill Blvd

Monrovia, CA 91016

(626) 358-1080

License: G60028

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Tran, Jennie OD

855 W Foothill Blvd

Monrovia, CA 91016

(626) 358-1080

License: 14276

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: No

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Villegas, Rex OD

855 W Foothill Blvd

Monrovia, CA 91016

(626) 358-1080

License: 12668

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: No

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

MONTEBELLO

90640

Corona, Fabian OD

1818 W Beverly Blvd Ste 105

Montebello, CA 90640

(323) 888-2020

License: 14923

Accepting New Members: Yes

Hours: TU-TH 12PM-7PM, F

2PM-6PM, SA 8:30AM-1:30PM

PTA: Yes

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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: 05-FEB-20

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

287

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LOS ANGELES COUNTY VISION PROVIDERS

Members should call the

Corona, Fabian OD provider’s office to discuss Garcia, Eddie MD

1818 W Beverly Blvd Ste 105 their accessibility needs when 2446 W Whittier Blvd

Montebello, CA 90640 there is limited access or when Montebello, CA 90640

(323) 888-2020 accessibility indicators are not (323) 728-5500

License: 14923 present. License: G53767

Accepting New Members: Yes UPDATE: There was a change Accepting New Members: Yes

Hours: Contact facility for in the provider record; Hours: M-F 9AM-6PM

hours of operation demographic, phone and/or PTA: Yes

PTA: No panel status. Other Language: Spanish

Other Language: Spanish Cultural Competency: CC

Cultural Competency: CC Accessibility: P, EB, IB, E, R;

Accessibility: P, EB, IB, E, R; Dominguez, Charles OD Members should call the

Members should call the 2446 W Whittier Blvd provider’s office to discuss

provider’s office to discuss Montebello, CA 90640 their accessibility needs when

their accessibility needs when (323) 728-5500 there is limited access or when

there is limited access or when License: 12292 accessibility indicators are not

accessibility indicators are not Accepting New Members: Yes present.

present. Hours: M-F 9AM-6PM UPDATE: There was a change

UPDATE: TERMED Provider. PTA: Yes in the provider record;

Effective Date: 04-FEB-20 Other Language: Spanish demographic, phone and/or

Cultural Competency: CC panel status.

Accessibility: P, EB, IB, E, R;

De La Pena, William MD Members should call the

2446 W Whittier Blvd provider’s office to discuss Larcabal, John OD

Montebello, CA 90640 their accessibility needs when 1818 W Beverly Blvd Ste 105

(323) 728-5500 there is limited access or when Montebello, CA 90640

License: A31272 accessibility indicators are not (323) 888-2020

Accepting New Members: Yes present. License: 9029

Hours: M-F 9AM-6PM UPDATE: There was a change Accepting New Members: Yes

PTA: Yes in the provider record; Hours: Contact facility for

Other Language: Spanish demographic, phone and/or hours of operation

Cultural Competency: CC panel status. PTA: No

Accessibility: P, EB, IB, E, R; Other Language: Spanish

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

288

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LOS ANGELES COUNTY VISION PROVIDERS

Cultural Competency: CC Accessibility: P, EB, IB, E, R;

Accessibility: P, EB, IB, E, R; Mayberry, Melissa MD Members should call the

Members should call the 2446 W Whittier Blvd provider’s office to discuss

provider’s office to discuss Montebello, CA 90640 their accessibility needs when

their accessibility needs when (323) 728-5500 there is limited access or when

there is limited access or when License: A71074 accessibility indicators are not

accessibility indicators are not Accepting New Members: Yes present.

present. Hours: M-F 9AM-6PM UPDATE: There was a change

UPDATE: TERMED Provider. PTA: Yes in the provider record;

Effective Date: 04-FEB-20 Other Language: Spanish demographic, phone and/or

Cultural Competency: CC panel status.

Accessibility: P, EB, IB, E, R;

Mandel, Benjamin MD Members should call the

2446 W Whittier Blvd provider’s office to discuss Moayedpardazi, Hamideh MD

Montebello, CA 90640 their accessibility needs when 2446 W Whittier Blvd

(323) 728-5500 there is limited access or when Montebello, CA 90640

License: A127151 accessibility indicators are not (323) 728-5500

Accepting New Members: Yes present. License: A137200

Hours: M-F 9AM-6PM UPDATE: There was a change Accepting New Members: Yes

PTA: Yes in the provider record; Hours: M-F 9AM-6PM

Other Language: Spanish demographic, phone and/or PTA: Yes

Cultural Competency: CC panel status. Other Language: Spanish

Accessibility: P, EB, IB, E, R; Cultural Competency: CC

Members should call the Accessibility: P, EB, IB, E, R;

provider’s office to discuss Mishima, Todd OD Members should call the

their accessibility needs when 2446 W Whittier Blvd provider’s office to discuss

there is limited access or when Montebello, CA 90640 their accessibility needs when

accessibility indicators are not (323) 728-5500 there is limited access or when

present. License: 9700 accessibility indicators are not

UPDATE: There was a change Accepting New Members: Yes present.

in the provider record; Hours: M-F 9AM-6PM UPDATE: There was a change

demographic, phone and/or PTA: Yes in the provider record;

panel status. Other Language: Spanish demographic, phone and/or

Cultural Competency: CC panel status.

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

289

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LOS ANGELES COUNTY VISION PROVIDERS

Nguyen, Meggie OD

2446 W Whittier Blvd

Montebello, CA 90640

(323) 728-5500

License: 15342

Accepting New Members: Yes

Hours: M-F 9AM-6PM

PTA: Yes

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Nguyen, Thien Thu OD

2446 W Whittier Blvd

Montebello, CA 90640

(323) 728-5500

License: 13098

Accepting New Members: Yes

Hours: M-F 9AM-6PM

PTA: Yes

Other Language: Spanish,

Vietnamese

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Perez, Evelyn OD

2446 W Whittier Blvd

Montebello, CA 90640

(323) 728-5500

License: 10155

Accepting New Members: Yes

Hours: M-F 9AM-6PM

PTA: Yes

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Salado, Maria OD

1818 W Beverly Blvd Ste 105

Montebello, CA 90640

(323) 888-2020

License: 33396

Accepting New Members: Yes

Hours: TU-TH 12PM-7PM, F

2PM-6PM, SA 8:30AM-1:30PM

PTA: Yes

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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: 05-FEB-20

Salib, George MD

2446 W Whittier Blvd

Montebello, CA 90640

(323) 728-5500

License: A71222

Accepting New Members: Yes

Hours: M-F 9AM-6PM

PTA: Yes

Other Language: Spanish

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

290

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LOS ANGELES COUNTY VISION PROVIDERS

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Sanchez, Adriana OD

2446 W Whittier Blvd

Montebello, CA 90640

(323) 728-5500

License: 14769

Accepting New Members: Yes

Hours: M-F 9AM-6PM

PTA: Yes

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Sanchez, Martha OD

1818 W Beverly Blvd Ste 105

Montebello, CA 90640

(323) 888-2020

License: 9494

Accepting New Members: Yes

Hours: TU-TH 12PM-7PM, F

2PM-6PM, SA 8:30AM-1:30PM

PTA: Yes

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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: 05-FEB-20

Sanchez, Martha OD

1818 W Beverly Blvd Ste 105

Montebello, CA 90640

(323) 888-2020

License: 9494

Accepting New Members: Yes

Hours: Contact facility for

hours of operation

PTA: No

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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: TERMED Provider.

Effective Date: 04-FEB-20

Uchio, Alejandra MD

2446 W Whittier Blvd

Montebello, CA 90640

(323) 728-5500

License: A78760

Accepting New Members: Yes

Hours: M-F 9AM-6PM

PTA: Yes

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

291

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LOS ANGELES COUNTY VISION PROVIDERS

Ung, Susan OD

2446 W Whittier Blvd

Montebello, CA 90640

(323) 728-5500

License: 12206

Accepting New Members: Yes

Hours: M-F 9AM-6PM

PTA: Yes

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

NORTH HILLS

91343

Cheung, Karen OD

9119 Haskell Ave

North Hills, CA 91343

(818) 763-8836

License: 11865

Accepting New Members: Yes

Hours: M-F 8AM-5PM, SA

8AM-3PM

PTA: No

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Sugimoto, Jean OD

9119 Haskell Ave

North Hills, CA 91343

(818) 763-8836

License: 33478

Accepting New Members: Yes

Hours: M-F 8AM-5PM, SA

8AM-3PM

PTA: No

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Zarabian, Elham OD

9119 Haskell Ave

North Hills, CA 91343

(818) 763-8836

License: 11991

Accepting New Members: Yes

Hours: M-F 8AM-5PM, SA

8AM-3PM

PTA: No

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

NORTH HOLLYWOOD

91605

Cheung, Karen OD

6801 Coldwater Canyon Ave

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

292

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LOS ANGELES COUNTY VISION PROVIDERS

North Hollywood, CA 91605

(818) 764-7047

License: 11865

Accepting New Members: Yes

Hours: M-F 8AM-5PM, SA

8AM-3PM

PTA: No

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Sugimoto, Jean OD

6801 Coldwater Canyon Ave

North Hollywood, CA 91605

(818) 764-7047

License: 33478

Accepting New Members: Yes

Hours: M-F 8AM-5PM, SA

8AM-3PM

PTA: No

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Zarabian, Elham OD

6801 Coldwater Canyon Ave

North Hollywood, CA 91605

(818) 764-7047

License: 11991

Accepting New Members: Yes

Hours: M-F 8AM-5PM, SA

8AM-3PM

PTA: No

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

NORTHRIDGE

91324

Winston, Mark OD

9153 Reseda Blvd

Northridge, CA 91324

(818) 701-0123

License: 7679

Accepting New Members: Yes

Hours: TU 9AM-6PM, W

9AM-5PM, TH 11AM-8PM, F

10AM-6PM

PTA: Yes

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

91325

Chang, Andrew MD

18350 Roscoe Blvd Ste 101

Northridge, CA 91325

(818) 349-8300

License: G61183

Accepting New Members: Yes

Hours: M-F 8:30AM-5PM

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

293

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LOS ANGELES COUNTY VISION PROVIDERS

PTA: No

Other Language: Spanish,

Chinese

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

NORWALK

90650

Ciampa, Christopher OD

10949 Alondra Blvd

Norwalk, CA 90650

(562) 864-8590

License: 8948

Accepting New Members: Yes

Hours: M,TU,F 9AM-5PM, W,TH

9AM-7PM, SA 9AM-4PM

PTA: No

Other Language: Bulgarian,

Russian, Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Fishberg, Gary OD

12413 Norwalk Blvd

Norwalk, CA 90650

(562) 863-5807

License: 6656

Accepting New Members: Yes

Hours: M,F 9AM-6:30PM, TU,TH

9AM-5PM, W 9AM-6PM, SA

8:30AM-1:30PM

PTA: No

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Goodwin Jr, Lawrence MD

11916 Firestone Blvd

Norwalk, CA 90650

(562) 868-6826

License: C40581

Accepting New Members: Yes

Hours: M 11AM-5PM, TU,F

10:30AM-6PM, W

10:30AM-5PM, TH

10:30AM-9PM, SA

10:30AM-2PM

PTA: Yes

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

To, Brittany OD

13800 San Antonio Dr

Norwalk, CA 90650

(562) 864-6535

License: 10651

Accepting New Members: Yes

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

294

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LOS ANGELES COUNTY VISION PROVIDERS

Hours: M-F 8:30AM-6PM, SA

8AM-2PM

PTA: Yes

Other Language: Spanish,

Vietnamese

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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: 07-FEB-20

PALMDALE

93550

Nghiem, Janet OD

516 E Palmdale Blvd

Palmdale, CA 93550

(661) 273-7200

License: 12843

Accepting New Members: Yes

Hours: M-F 9AM-5PM, SA

9AM-1PM

PTA: Yes

Other Language: Vietnamese

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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: TERMED Provider.

Effective Date: 19-FEB-20

PARAMOUNT

90723

Ciampa, Christopher OD

15717 Paramount Blvd

Paramount, CA 90723

(562) 361-5515

License: 8948

Accepting New Members: Yes

Hours: M-F 9AM-5PM

PTA: No

Other Language: Bulgarian,

Russian, Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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

Chang, Andrew MD

625 S Fair Oaks Ave Ste 235

Pasadena, CA 91105

(626) 796-7006

License: G61183

Accepting New Members: Yes

Hours: M 9AM-5PM, TU-TH

8AM-5PM, F 8AM-4PM

PTA: No

Other Language: Spanish,

Chinese

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Chang, Tom MD

100 E California Blvd

Pasadena, CA 91105

(800) 432-2020

License: A69909

Accepting New Members: Yes

Hours: M-F 8AM-5PM

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

295

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LOS ANGELES COUNTY VISION PROVIDERS

PTA: No

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Davis, Michael MD

100 E California Blvd

Pasadena, CA 91105

(800) 432-2020

License: A111866

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: No

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Kim, Melody OD

100 E California Blvd

Pasadena, CA 91105

(800) 432-2020

License: 14726

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: No

Other Language: Korean,

Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Malek, Renia OD

100 E California Blvd

Pasadena, CA 91105

(800) 432-2020

License: 33840

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: No

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

91107

Amini, Payam MD

2619 E Colorado Blvd Ste 150

Pasadena, CA 91107

(626) 793-4168

License: A107595

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: No

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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;

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

296

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LOS ANGELES COUNTY VISION PROVIDERS

demographic, phone and/or

panel status.

Cairnie, Mary OD

2619 E Colorado Blvd Ste 150

Pasadena, CA 91107

(626) 793-4168

License: 33545

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: No

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Camara, David OD

2619 E Colorado Blvd Ste 150

Pasadena, CA 91107

(626) 793-4168

License: 10484

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: No

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Chu, Selena OD

2619 E Colorado Blvd Ste 150

Pasadena, CA 91107

(626) 793-4168

License: 33549

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: No

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Diggory, Matthew OD

2619 E Colorado Blvd Ste 150

Pasadena, CA 91107

(626) 793-4168

License: 33521

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: No

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Duan, Deborah OD

2619 E Colorado Blvd Ste 150

Pasadena, CA 91107

(626) 793-4168

License: 34232

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: No

Other Language: Chinese

Cultural Competency: CC

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

297

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LOS ANGELES COUNTY VISION PROVIDERS

Accessibility: P, EB, IB, E, R; Accessibility: P, EB, IB, E, R;

Members should call the Members should call the

provider’s office to discuss Luke, Priscilla MD provider’s office to discuss

their accessibility needs when 2619 E Colorado Blvd Ste 150 their accessibility needs when

there is limited access or when Pasadena, CA 91107 there is limited access or when

accessibility indicators are not (626) 793-4168 accessibility indicators are not

present. License: A107548 present.

UPDATE: There was a change Accepting New Members: Yes UPDATE: There was a change

in the provider record; Hours: M-F 8AM-5PM in the provider record;

demographic, phone and/or PTA: No demographic, phone and/or

panel status. Cultural Competency: CC panel status.

Accessibility: P, EB, IB, E, R;

Members should call the

Huang, Jeffrey DO provider’s office to discuss Ochoa, Araceli OD

2619 E Colorado Blvd Ste 150 their accessibility needs when 2619 E Colorado Blvd Ste 150

Pasadena, CA 91107 there is limited access or when Pasadena, CA 91107

(626) 793-4168 accessibility indicators are not (626) 793-4168

License: 20A11984 present. License: 33514

Accepting New Members: Yes UPDATE: There was a change Accepting New Members: Yes

Hours: M-F 8AM-5PM in the provider record; Hours: M-F 8AM-5PM

PTA: No demographic, phone and/or PTA: No

Other Language: Chinese panel status. Other Language: Spanish

Cultural Competency: CC Cultural Competency: CC

Accessibility: P, EB, IB, E, R; Accessibility: P, EB, IB, E, R;

Members should call the Moore, Lori MD Members should call the

provider’s office to discuss 2619 E Colorado Blvd Ste 150 provider’s office to discuss

their accessibility needs when Pasadena, CA 91107 their accessibility needs when

there is limited access or when (626) 793-4168 there is limited access or when

accessibility indicators are not License: G57630 accessibility indicators are not

present. Accepting New Members: Yes present.

UPDATE: There was a change Hours: M-F 8AM-5PM UPDATE: There was a change

in the provider record; PTA: No in the provider record;

demographic, phone and/or Other Language: Spanish demographic, phone and/or

panel status. Cultural Competency: CC panel status.

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

298

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LOS ANGELES COUNTY VISION PROVIDERS

Ong, Olivia MD

2619 E Colorado Blvd Ste 150

Pasadena, CA 91107

(626) 793-4168

License: A66933

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: No

Other Language: Burmese,

Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Patel, Jay MD

2619 E Colorado Blvd Ste 150

Pasadena, CA 91107

(626) 793-4168

License: A127433

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: No

Other Language: Gujarati,

Hindi, Polish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Rezaei Abbassi, Nima MD

2619 E Colorado Blvd Ste 150

Pasadena, CA 91107

(626) 793-4168

License: A131669

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: No

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Shaw, Minh OD

2619 E Colorado Blvd Ste 150

Pasadena, CA 91107

(626) 793-4168

License: 13540

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: No

Other Language: Vietnamese

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Shelton, Raymond MD

2619 E Colorado Blvd Ste 150

Pasadena, CA 91107

(626) 793-4168

License: G60028

Accepting New Members: Yes

Hours: M-F 8AM-5PM

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

299

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LOS ANGELES COUNTY VISION PROVIDERS

PTA: No

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Tran, Jennie OD

2619 E Colorado Blvd Ste 150

Pasadena, CA 91107

(626) 793-4168

License: 14276

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: No

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Villegas, Rex OD

2619 E Colorado Blvd Ste 150

Pasadena, CA 91107

(626) 793-4168

License: 12668

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: No

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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

91767

Bedrood, Sahar MD

160 E Artesia St Ste 120

Pomona, CA 91767

(909) 629-5965

License: A124192

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: Yes

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Tran, Dai MD

1148 E Holt Ave

Pomona, CA 91767

(909) 622-2226

License: G83981

Accepting New Members: Yes

Hours: M-F 9AM-6PM, SA

10AM-5PM

PTA: No

Other Language: Spanish,

Vietnamese

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

Members should call the

provider’s office to discuss

their accessibility needs when

there is limited access or when

accessibility indicators are not

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

300

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LOS ANGELES COUNTY VISION PROVIDERS

present.

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

ROSEMEAD

91770

Eng, Calvin MD

9212 Valley Blvd

Rosemead, CA 91770

(626) 288-2308

License: G55239

Accepting New Members: Yes

Hours: M-SA 10AM-6PM

PTA: No

Other Language: Spanish,

Vietnamese, Chinese

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Tran, Dai MD

9014 Garvey Ave Ste G

Rosemead, CA 91770

(626) 572-7171

License: G83981

Accepting New Members: Yes

Hours: M-TH 9AM-1PM, F

9AM-6PM, SA 1PM-5PM

PTA: No

Other Language: Spanish,

Vietnamese

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

ROWLAND HEIGHTS

91748

Chang, Bogard OD

18337 Colima Rd

Rowland Heights, CA 91748

(626) 854-1131

License: 11253

Accepting New Members: Yes

Hours: M-F 9AM-6PM, SA

9AM-4PM

PTA: Yes

Other Language: Chinese

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Yang, Catherine OD

1015 Nogales St Ste 109

Rowland Heights, CA 91748

(626) 965-8698

License: 33582

Accepting New Members: Yes

Hours: M-SU 9AM-7PM

PTA: No

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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: 14-FEB-20

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

301

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LOS ANGELES COUNTY VISION PROVIDERS

SAN DIMAS

91773

Yu, Elaine OD

120 W Bonita Ave Ste A

San Dimas, CA 91773

(909) 599-1100

License: 34447

Accepting New Members: Yes

Hours: M,W,TH 8:30AM-5:30PM,

TU 10AM-6:30PM, F 7AM-4PM

PTA: Yes

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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: 10-JAN-20

SAN GABRIEL

91776

Chen, Brian MD

207 S Santa Anita St Ste P25

San Gabriel, CA 91776

(626) 269-5355

License: A127719

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: No

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Kim, Melody OD

207 S Santa Anita St Ste P25

San Gabriel, CA 91776

(626) 269-5355

License: 14726

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: No

Other Language: Korean,

Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Lao, Jia OD

140 W Valley Blvd Ste 115

San Gabriel, CA 91776

(626) 288-8023

License: 14574

Accepting New Members: Yes

Hours: M-SU 9:30AM-8:30PM

PTA: Yes

Other Language: Chinese

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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: TERMED Provider.

Effective Date: 24-FEB-20

Lin, Esther OD

1045 E Valley Blvd Ste 202

San Gabriel, CA 91776

(626) 280-6212

License: 33975

Accepting New Members: Yes

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

302

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LOS ANGELES COUNTY VISION PROVIDERS

Hours: M,W,F 10AM-7PM, TU,SA

9AM-5PM

PTA: No

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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: TERMED Provider.

Effective Date: 14-FEB-20

Wainess, Reid MD

207 S Santa Anita St Ste P25

San Gabriel, CA 91776

(626) 269-5355

License: A108766

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: No

Other Language: Hebrew,

Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Yang, Catherine OD

140 W Valley Blvd Ste 115

San Gabriel, CA 91776

(626) 288-8023

License: 33582

Accepting New Members: Yes

Hours: M-SU 9:30AM-8:30PM

PTA: Yes

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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: 14-FEB-20

SAN PEDRO

90732

Alasil, Tarek MD

1360 W 6th St Ste 165

San Pedro, CA 90732

(562) 317-3892

License: A108797

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: Yes

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Chang, Tom MD

1360 W 6th St Ste 165

San Pedro, CA 90732

(562) 317-3892

License: A69909

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: Yes

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

303

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LOS ANGELES COUNTY VISION PROVIDERS

panel status.

Dang, Lisa MD

1360 W 6th St Ste 165

San Pedro, CA 90732

(562) 317-3892

License: A154089

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: Yes

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Nguyen, Thy OD

1360 W 6th St Ste 165

San Pedro, CA 90732

(562) 317-3892

License: 12746

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: Yes

Other Language: Spanish,

Vietnamese

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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, Vy OD

1360 W 6th St Ste 165

San Pedro, CA 90732

(562) 317-3892

License: 33671

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: Yes

Other Language: Vietnamese

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Wong, Sharon OD

1360 W 6th St Ste 165

San Pedro, CA 90732

(562) 317-3892

License: 15137

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

SANTA MONICA

90404

Wong, King OD

1526 14th St Ste 101

Santa Monica, CA 90404

(310) 395-2106

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

304

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LOS ANGELES COUNTY VISION PROVIDERS

License: 12461

Accepting New Members: Yes

Hours: M-F 9AM-7PM, SA

9AM-2PM

PTA: Yes

Other Language: Spanish,

Chinese

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

SHERMAN OAKS

91423

Gabrielian, Karine MD

13739 Riverside Dr Ste A

Sherman Oaks, CA 91423

(818) 386-0008

License: A66613

Accepting New Members: Yes

Hours: M-SA 9AM-6PM

PTA: Yes

Other Language: Armenian,

Russian

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Hovanesian, Haroutun MD

13739 Riverside Dr Ste A

Sherman Oaks, CA 91423

(818) 386-0008

License: A67565

Accepting New Members: Yes

Hours: M-SA 9AM-6PM

PTA: Yes

Other Language: Armenian,

Russian, Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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 PASADENA

91030

Latter, Mitchell MD

1499 Huntington Dr Ste 508

South Pasadena, CA 91030

(626) 799-9588

License: G40013

Accepting New Members: Yes

Hours: M,W,F 9AM-5PM, TU

1:30PM-5PM

PTA: No

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Tom, Wesley OD

1024 Mission St Ste B

South Pasadena, CA 91030

(626) 460-6022

License: 9469

Accepting New Members: Yes

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

305

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LOS ANGELES COUNTY VISION PROVIDERS

Hours: M,W 10AM-6PM, TU,F

9AM-5PM, TH 11AM-7PM, SA

10AM-3PM

PTA: Yes

Other Language: Spanish,

Chinese

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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: 17-JAN-20

STEVENSON RANCH

91381

Winston, Mark OD

25834 The Old Rd

Stevenson Ranch, CA 91381

(661) 259-3300

License: 7679

Accepting New Members: Yes

Hours: M,W 9AM-6PM, TU,F

9AM-5PM, TH 9AM-1PM, SA

9AM-4PM

PTA: No

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

TARZANA

91356

Amini, Payam MD

18370 Burbank Blvd Ste 207

Tarzana, CA 91356

(818) 996-3400

License: A107595

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: Yes

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Cairnie, Mary OD

18370 Burbank Blvd Ste 207

Tarzana, CA 91356

(818) 996-3400

License: 33545

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: Yes

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Camara, David OD

18370 Burbank Blvd Ste 207

Tarzana, CA 91356

(818) 996-3400

License: 10484

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: Yes

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

Members should call the

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

306

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LOS ANGELES COUNTY VISION PROVIDERS

provider’s office to discuss 18370 Burbank Blvd Ste 207 their accessibility needs when

their accessibility needs when Tarzana, CA 91356 there is limited access or when

there is limited access or when (818) 996-3400 accessibility indicators are not

accessibility indicators are not License: 33521 present.

present. Accepting New Members: Yes UPDATE: There was a change

UPDATE: There was a change Hours: M-F 8AM-5PM in the provider record;

in the provider record; PTA: Yes demographic, phone and/or

demographic, phone and/or Cultural Competency: CC panel status.

panel status. Accessibility: P, EB, IB, E, R;

Members should call the

provider’s office to discuss Huang, Jeffrey DO

Chu, Selena OD their accessibility needs when 18370 Burbank Blvd Ste 207

18370 Burbank Blvd Ste 207 there is limited access or when Tarzana, CA 91356

Tarzana, CA 91356 accessibility indicators are not (818) 996-3400

(818) 996-3400 present. License: 20A11984

License: 33549 UPDATE: There was a change Accepting New Members: Yes

Accepting New Members: Yes in the provider record; Hours: M-F 8AM-5PM

Hours: M-F 8AM-5PM demographic, phone and/or PTA: Yes

PTA: Yes panel status. Other Language: Chinese

Cultural Competency: CC Cultural Competency: CC

Accessibility: P, EB, IB, E, R; Accessibility: P, EB, IB, E, R;

Members should call the Duan, Deborah OD Members should call the

provider’s office to discuss 18370 Burbank Blvd Ste 207 provider’s office to discuss

their accessibility needs when Tarzana, CA 91356 their accessibility needs when

there is limited access or when (818) 996-3400 there is limited access or when

accessibility indicators are not License: 34232 accessibility indicators are not

present. Accepting New Members: Yes present.

UPDATE: There was a change Hours: M-F 8AM-5PM UPDATE: There was a change

in the provider record; PTA: Yes in the provider record;

demographic, phone and/or Other Language: Chinese demographic, phone and/or

panel status. Cultural Competency: CC panel status.

Accessibility: P, EB, IB, E, R;

Members should call the

Diggory, Matthew OD provider’s office to discuss Luke, Priscilla MD

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

307

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LOS ANGELES COUNTY VISION PROVIDERS

18370 Burbank Blvd Ste 207 their accessibility needs when 18370 Burbank Blvd Ste 207

Tarzana, CA 91356 there is limited access or when Tarzana, CA 91356

(818) 996-3400 accessibility indicators are not (818) 996-3400

License: A107548 present. License: A66933

Accepting New Members: Yes UPDATE: There was a change Accepting New Members: Yes

Hours: M-F 8AM-5PM in the provider record; Hours: M-F 8AM-5PM

PTA: Yes demographic, phone and/or PTA: Yes

Cultural Competency: CC panel status. Other Language: Burmese,

Accessibility: P, EB, IB, E, R; Spanish

Members should call the Cultural Competency: CC

provider’s office to discuss Ochoa, Araceli OD Accessibility: P, EB, IB, E, R;

their accessibility needs when 18370 Burbank Blvd Ste 207 Members should call the

there is limited access or when Tarzana, CA 91356 provider’s office to discuss

accessibility indicators are not (818) 996-3400 their accessibility needs when

present. License: 33514 there is limited access or when

UPDATE: There was a change Accepting New Members: Yes accessibility indicators are not

in the provider record; Hours: M-F 8AM-5PM present.

demographic, phone and/or PTA: Yes UPDATE: There was a change

panel status. Other Language: Spanish in the provider record;

Cultural Competency: CC demographic, phone and/or

Accessibility: P, EB, IB, E, R; panel status.

Moore, Lori MD Members should call the

18370 Burbank Blvd Ste 207 provider’s office to discuss

Tarzana, CA 91356 their accessibility needs when Patel, Jay MD

(818) 996-3400 there is limited access or when 18370 Burbank Blvd Ste 207

License: G57630 accessibility indicators are not Tarzana, CA 91356

Accepting New Members: Yes present. (818) 996-3400

Hours: M-F 8AM-5PM UPDATE: There was a change License: A127433

PTA: Yes in the provider record; Accepting New Members: Yes

Other Language: Spanish demographic, phone and/or Hours: M-F 8AM-5PM

Cultural Competency: CC panel status. PTA: Yes

Accessibility: P, EB, IB, E, R; Other Language: Gujarati,

Members should call the Hindi, Polish

provider’s office to discuss Ong, Olivia MD Cultural Competency: CC

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

308

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LOS ANGELES COUNTY VISION PROVIDERS

Accessibility: P, EB, IB, E, R; Accessibility: P, EB, IB, E, R;

Members should call the Members should call the

provider’s office to discuss Shelton, Raymond MD provider’s office to discuss

their accessibility needs when 18370 Burbank Blvd Ste 207 their accessibility needs when

there is limited access or when Tarzana, CA 91356 there is limited access or when

accessibility indicators are not (818) 996-3400 accessibility indicators are not

present. License: G60028 present.

UPDATE: There was a change Accepting New Members: Yes UPDATE: There was a change

in the provider record; Hours: M-F 8AM-5PM in the provider record;

demographic, phone and/or PTA: Yes demographic, phone and/or

panel status. Other Language: Spanish panel status.

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

Shaw, Minh OD Members should call the Villegas, Rex OD

18370 Burbank Blvd Ste 207 provider’s office to discuss 18370 Burbank Blvd Ste 207

Tarzana, CA 91356 their accessibility needs when Tarzana, CA 91356

(818) 996-3400 there is limited access or when (818) 996-3400

License: 13540 accessibility indicators are not License: 12668

Accepting New Members: Yes present. Accepting New Members: Yes

Hours: M-F 8AM-5PM UPDATE: There was a change Hours: M-F 8AM-5PM

PTA: Yes in the provider record; PTA: Yes

Other Language: Vietnamese demographic, phone and/or Cultural Competency: CC

Cultural Competency: CC panel status. Accessibility: P, EB, IB, E, R;

Accessibility: P, EB, IB, E, R; Members should call the

Members should call the provider’s office to discuss

provider’s office to discuss Tran, Jennie OD their accessibility needs when

their accessibility needs when 18370 Burbank Blvd Ste 207 there is limited access or when

there is limited access or when Tarzana, CA 91356 accessibility indicators are not

accessibility indicators are not (818) 996-3400 present.

present. License: 14276 UPDATE: There was a change

UPDATE: There was a change Accepting New Members: Yes in the provider record;

in the provider record; Hours: M-F 8AM-5PM demographic, phone and/or

demographic, phone and/or PTA: Yes panel status.

panel status. Cultural Competency: CC

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

309

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LOS ANGELES COUNTY VISION PROVIDERS

TORRANCE

90505

Alasil, Tarek MD

3440 Lomita Blvd Ste 100

Torrance, CA 90505

(800) 898-2020

License: A108797

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: Yes

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Casey, Richard MD

23000 Crenshaw Blvd Ste 100

Torrance, CA 90505

(310) 803-9633

License: G69608

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: Yes

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Chang, Bogard OD

23133 Hawthorne Blvd Ste 110

Torrance, CA 90505

(310) 375-8028

License: 11253

Accepting New Members: Yes

Hours: M 10AM-4PM, TU,F,SA

10AM-6PM

PTA: No

Other Language: Chinese

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Chang, Tom MD

3440 Lomita Blvd Ste 100

Torrance, CA 90505

(800) 898-2020

License: A69909

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: Yes

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Dang, Lisa MD

3440 Lomita Blvd Ste 100

Torrance, CA 90505

(800) 898-2020

License: A154089

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: Yes

Cultural Competency: CC

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

310

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LOS ANGELES COUNTY VISION PROVIDERS

Accessibility: P, EB, IB, E, R; Cultural Competency: CC

Members should call the Grattan, Anne OD Accessibility: P, EB, IB, E, R;

provider’s office to discuss 23000 Crenshaw Blvd Ste 100 Members should call the

their accessibility needs when Torrance, CA 90505 provider’s office to discuss

there is limited access or when (310) 803-9633 their accessibility needs when

accessibility indicators are not License: 15086 there is limited access or when

present. Accepting New Members: Yes accessibility indicators are not

UPDATE: There was a change Hours: M-F 8AM-5PM present.

in the provider record; PTA: Yes UPDATE: There was a change

demographic, phone and/or Other Language: Spanish, in the provider record;

panel status. Vietnamese demographic, phone and/or

Cultural Competency: CC panel status.

Accessibility: P, EB, IB, E, R;

Grant-acquah, Kweku MD Members should call the

3440 Lomita Blvd Ste 100 provider’s office to discuss Jalalat, Parisa OD

Torrance, CA 90505 their accessibility needs when 23000 Crenshaw Blvd Ste 100

(800) 898-2020 there is limited access or when Torrance, CA 90505

License: A126202 accessibility indicators are not (310) 803-9633

Accepting New Members: Yes present. License: 33762

Hours: M-F 8AM-5PM UPDATE: There was a change Accepting New Members: Yes

PTA: Yes in the provider record; Hours: M-F 8AM-5PM

Cultural Competency: CC demographic, phone and/or PTA: Yes

Accessibility: P, EB, IB, E, R; panel status. Cultural Competency: CC

Members should call the Accessibility: P, EB, IB, E, R;

provider’s office to discuss Members should call the

their accessibility needs when Huynh, Anthony OD provider’s office to discuss

there is limited access or when 23000 Crenshaw Blvd Ste 100 their accessibility needs when

accessibility indicators are not Torrance, CA 90505 there is limited access or when

present. (310) 803-9633 accessibility indicators are not

UPDATE: There was a change License: 11426 present.

in the provider record; Accepting New Members: Yes UPDATE: There was a change

demographic, phone and/or Hours: M-F 8AM-5PM in the provider record;

panel status. PTA: Yes demographic, phone and/or

Other Language: Vietnamese panel status.

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

311

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LOS ANGELES COUNTY VISION PROVIDERS

Accessibility: P, EB, IB, E, R;

Members should call the

Kim, Janet Kiehong OD provider’s office to discuss Logan, Dwayne MD

23000 Crenshaw Blvd Ste 100 their accessibility needs when 23000 Crenshaw Blvd Ste 100

Torrance, CA 90505 there is limited access or when Torrance, CA 90505

(310) 803-9633 accessibility indicators are not (310) 803-9633

License: A123752 present. License: G68583

Accepting New Members: Yes UPDATE: There was a change Accepting New Members: Yes

Hours: M-F 8AM-5PM in the provider record; Hours: M-F 8AM-5PM

PTA: Yes demographic, phone and/or PTA: Yes

Cultural Competency: CC panel status. Cultural Competency: CC

Accessibility: P, EB, IB, E, R; Accessibility: P, EB, IB, E, R;

Members should call the Members should call the

provider’s office to discuss Le, Huong OD provider’s office to discuss

their accessibility needs when 23000 Crenshaw Blvd Ste 100 their accessibility needs when

there is limited access or when Torrance, CA 90505 there is limited access or when

accessibility indicators are not (310) 803-9633 accessibility indicators are not

present. License: 33843 present.

UPDATE: There was a change Accepting New Members: Yes UPDATE: There was a change

in the provider record; Hours: M-F 8AM-5PM in the provider record;

demographic, phone and/or PTA: Yes demographic, phone and/or

panel status. Other Language: Spanish panel status.

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

Lee, Scott OD Members should call the Montana Collins, Claudia OD

23000 Crenshaw Blvd Ste 100 provider’s office to discuss 23000 Crenshaw Blvd Ste 100

Torrance, CA 90505 their accessibility needs when Torrance, CA 90505

(310) 803-9633 there is limited access or when (310) 803-9633

License: 11911 accessibility indicators are not License: 12170

Accepting New Members: Yes present. Accepting New Members: Yes

Hours: M-F 8AM-5PM UPDATE: There was a change Hours: M-F 8AM-5PM

PTA: Yes in the provider record; PTA: Yes

Other Language: Spanish demographic, phone and/or Other Language: Spanish

Cultural Competency: CC panel status. Cultural Competency: CC

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

312

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LOS ANGELES COUNTY VISION PROVIDERS

Accessibility: P, EB, IB, E, R;

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.

Nguyen, Thy OD

3440 Lomita Blvd Ste 100

Torrance, CA 90505

(800) 898-2020

License: 12746

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: Yes

Other Language: Spanish,

Vietnamese

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Pazornik, Arthur OD

23000 Crenshaw Blvd Ste 100

Torrance, CA 90505

(310) 803-9633

License: 4978

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: Yes

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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, Vy OD

3440 Lomita Blvd Ste 100

Torrance, CA 90505

(800) 898-2020

License: 33671

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: Yes

Other Language: Vietnamese

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Sato, Ayaka OD

23000 Crenshaw Blvd Ste 100

Torrance, CA 90505

(310) 803-9633

License: 14212

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: Yes

Other Language: Japanese,

Korean

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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;

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

313

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LOS ANGELES COUNTY VISION PROVIDERS

demographic, phone and/or

panel status.

Tamayo, Robert OD

3525 Pacific Coast Hwy Ste E

Torrance, CA 90505

(310) 325-7799

License: 10737

Accepting New Members: Yes

Hours: M,TU,TH,F 9AM-6PM, SA

9AM-2PM

PTA: Yes

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Teshima, Donald OD

23000 Crenshaw Blvd Ste 100

Torrance, CA 90505

(310) 803-9633

License: 5954

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: Yes

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Tran, Mailan OD

23000 Crenshaw Blvd Ste 100

Torrance, CA 90505

(310) 803-9633

License: 13984

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: Yes

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Tu, Linh OD

3525 Pacific Coast Hwy Ste E

Torrance, CA 90505

(310) 325-7799

License: 11969

Accepting New Members: Yes

Hours: M,TU,TH,F 9AM-6PM, SA

9AM-2PM

PTA: Yes

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Varsani, Poonam OD

23000 Crenshaw Blvd Ste 100

Torrance, CA 90505

(310) 803-9633

License: 14909

Accepting New Members: Yes

Hours: M-F 8AM-5PM

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

314

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LOS ANGELES COUNTY VISION PROVIDERS

PTA: Yes

Other Language: Gujarati,

Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Watanabe, Dennis OD

23000 Crenshaw Blvd Ste 100

Torrance, CA 90505

(310) 803-9633

License: 7702

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: Yes

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Wong, Sharon OD

3440 Lomita Blvd Ste 100

Torrance, CA 90505

(800) 898-2020

License: 15137

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

VAN NUYS

91401

Gomes, Alex OD

5622 Van Nuys Blvd

Van Nuys, CA 91401

(818) 988-8744

License: 13501

Accepting New Members: Yes

Hours: M,TU,F 9AM-5PM, W,TH

10AM-6PM, SA 9AM-2PM

PTA: Yes

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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

91791

Kim, Stella OD

2233 E Garvey Ave N Ste A

West Covina, CA 91791

(626) 600-9486

License: 14985

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: Yes

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

Members should call the

provider’s office to discuss

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

315

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LOS ANGELES COUNTY VISION PROVIDERS

their accessibility needs when

there is limited access or when

accessibility indicators are not

present.

UPDATE: NEW Provider Added.

Effective_Date: 19-DEC-19

Maria, Aileen OD

2233 E Garvey Ave N Ste A

West Covina, CA 91791

(626) 600-9486

License: 33581

Accepting New Members: Yes

Hours: M-F 8AM-5PM

PTA: Yes

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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: 19-DEC-19

91792

Yee, Olave OD

3658 S Nogales St

West Covina, CA 91792

(626) 539-3543

License: 34131

Accepting New Members: Yes

Hours: M,TU,TH 10AM-7PM, W

10AM-6PM, F 9AM-6PM, SA

9AM-4PM

PTA: Yes

Other Language: French,

Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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: TERMED Provider.

Effective Date: 14-FEB-20

WEST HILLS

91304

Gomes, Alex OD

7606 Fallbrook Ave Ste 8

West Hills, CA 91304

(818) 476-7949

License: 13501

Accepting New Members: Yes

Hours: TU,W,F 9AM-5PM, SA

9AM-1PM

PTA: No

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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 HOLLYWOOD

90046

Gabrielian, Karine MD

7739 Santa Monica Blvd

West Hollywood, CA 90046

(323) 656-7771

License: A66613

Accepting New Members: Yes

Hours: M-F 9AM-6PM

PTA: No

Other Language: Armenian,

Russian

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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;

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

316

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LOS ANGELES COUNTY VISION PROVIDERS

demographic, phone and/or

panel status.

Hovanesian, Haroutun MD

7739 Santa Monica Blvd

West Hollywood, CA 90046

(323) 656-7771

License: A67565

Accepting New Members: Yes

Hours: M-F 9AM-6PM

PTA: No

Other Language: Armenian,

Russian, Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

WHITTIER

90601

Ordonez, Xavier OD

13124 Philadelphia St

Whittier, CA 90601

(562) 945-3589

License: 11089

Accepting New Members: Yes

Hours: M,TU,TH,F 9AM-5PM, W

10AM-6PM, SA 9AM-3PM

PTA: Yes

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

90602

Okie, Theodore MD

7957 Painter Ave Ste 203

Whittier, CA 90602

(562) 464-0590

License: G8937

Accepting New Members: Yes

Hours: M-TH 9AM-5PM, F

8AM-1PM

PTA: No

Other Language: Spanish

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Shammas, Hanna MD

7957 Painter Ave Ste 203

Whittier, CA 90602

(562) 464-0590

License: A30800

Accepting New Members: Yes

Hours: M-TH 9AM-5PM, F

8AM-1PM

PTA: No

Other Language: Arabic,

French

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

317

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LOS ANGELES COUNTY VISION PROVIDERS

Swearingen, Michael OD

7957 Painter Ave Ste 203

Whittier, CA 90602

(562) 464-0590

License: 5603

Accepting New Members: Yes

Hours: M-TH 9AM-5PM, F

8AM-1PM

PTA: No

Cultural Competency: CC

Accessibility: P, EB, IB, E, R;

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.

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

318

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LOS ANGELES COUNTY MENTAL HEALTH FACILITIES

REDONDO BEACH

90278

South Bay Family Health Care

- Redondo Beach

2114 Artesia Blvd

Redondo Beach, CA 90278

(310) 802-6170

NPI#: 1548301229

Hours: M,W,F 7:30AM-4:30PM,

TU,TH 10AM-7:30PM

PTA: No

Cultural Competency: NR

Accessibility: EB; 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-JUL-14

Accessiblity code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam

Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is

self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information

PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural

Competency reported NR: Cultural Competency not reported. Interpreting services are available for all

providers through Blue Shield Promise Cal MediconnectPlan at no cost. An advance notice is needed for

face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal

Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal

Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For

more information, visit www.blueshieldca.com/promise/calmediconnect. Call Member Services at

1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a week. , if you need information about a

facility’s licensing information, other credentials and/or certifications, and/or days and hours of operation.

This list is subject to change.

319

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LOS ANGELES COUNTY PHARMACIES

CULVER CITY

90230

RETAIL PHARMACIES

ARTESIA

90701

BURBANK

91506

Mercy Ltc And Specialty

Pharmacy •

11515 Artesia Blvd

Artesia, CA 90701

(562) 402-0542

TTY: 711

Hours: SA,SU 12AM-12AM, M-F

9AM-6PM

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

BELL GARDENS

90201

Bell Gardens Family Pharmacy

1 •

6501 Garfield Ave

Bell Gardens, CA 90201

(562) 776-5050

TTY: 711

Hours: SU 12AM-12AM, M-F

9AM-5PM, SA 9AM-3PM

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Pavilions Pharmacy 2214 •

1110 W Alameda Ave

Burbank, CA 91506

(818) 567-0086

TTY: 711

Hours: SA,SU 9AM-5PM, M-F

9AM-9PM

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

COVINA

91723

East Valley Pmq Covina

Pharmacy •

276 W College St

Covina, CA 91723

(000) 000-0000

TTY: 711

Hours: SA,SU 12AM-12AM, M-F

8:30AM-5PM

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Pavilions Pharmacy 2212 •

11030 Jefferson Blvd

Culver City, CA 90230

(310) 398-8044

TTY: 711

Hours: SA,SU 9AM-5PM, M-F

9AM-9PM

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

EL MONTE

91731

Health Mart Midway •

10410 Lower Azusa Rd Ste 102

El Monte, CA 91731

(626) 448-7659

TTY: 711

Hours: SA,SU 12AM-12AM, M-F

8:30AM-5:30PM

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

91733

Rosa 1 Pharmacy 2547 •

•=This pharmacy supports electronic prescribing.

•= Extended supply of maintenance medications available at this location.

You can go to any of the pharmacies in our network

Interpreting services are available for all providers through Blue Shield Promise Cal Mediconnect Plan at

no cost. An advance notice is needed for face-to- face and ASL interpreting services. To request services,

contact Blue Shield Promise Cal Mediconnect Plan Member Services. If you have questions, please call

Blue Shield Promise Cal Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a

week. The call is free. For more information, visit www.blueshieldca.com/promise/calmediconnect.

This list is subject to change

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LOS ANGELES COUNTY PHARMACIES

10366 Garvey Ave Ste B

El Monte, CA 91733

(626) 448-9956

TTY: 711

Hours: SU 12AM-12AM, M-F

9AM-6PM, SA 9:30AM-2PM

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

ENCINO

91436

Encino Care Pharmacy •

16025 Ventura Blvd Ste 100

Encino, CA 91436

(818) 377-6900

TTY: 711

Hours: SU 12AM-12AM, M-F

9AM-6PM, SA 10AM-2PM

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

GARDENA

90247

Vons Pharmacy 1625 •

1260 W Redondo Beach Blvd

Gardena, CA 90247

(310) 767-7940

TTY: 711

Hours: SA,SU 9AM-5PM, M-F

9AM-9PM

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

GLENDALE

91201

Remedy Drugs •

1700 W Glenoaks Blvd

Glendale, CA 91201

(818) 549-1010

TTY: 711

Hours: SU 12AM-12AM, M-F

9AM-6PM, SA 9AM-1PM

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

91205

Glendale West Pharmacy •

1109 S Glendale Ave

Glendale, CA 91205

(818) 548-5157

TTY: 711

Hours: SU 12AM-12AM, M-F

9AM-6PM, SA 10AM-3PM

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

I And G Pharmacy Inc •

815 E Colorado St Ste A

Glendale, CA 91205

(818) 500-0895

TTY: 711

Hours: SA,SU 12AM-12AM, M-F

9:30AM-5:30PM

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

LONG BEACH

90806

Pacific Plaza Pharmacy

5624266588 •

2777 Pacific Ave Ste A

Long Beach, CA 90806

(562) 426-6588

TTY: 711

Hours: SA,SU 12AM-12AM, M-F

9:30AM-5:30PM

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

•=This pharmacy supports electronic prescribing.

•= Extended supply of maintenance medications available at this location.

You can go to any of the pharmacies in our network

Interpreting services are available for all providers through Blue Shield Promise Cal Mediconnect Plan at

no cost. An advance notice is needed for face-to- face and ASL interpreting services. To request services,

contact Blue Shield Promise Cal Mediconnect Plan Member Services. If you have questions, please call

Blue Shield Promise Cal Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a

week. The call is free. For more information, visit www.blueshieldca.com/promise/calmediconnect.

This list is subject to change

321

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LOS ANGELES COUNTY PHARMACIES

LOS ANGELES

90015

Cvs Pharmacy 11028 •

1026 S Broadway Spc A

Los Angeles, CA 90015

(000) 000-0000

TTY: 711

Hours: M-SU 12AM-11:59PM

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

90017

Good Samaritan Total Care

Pharmacy •

1245 Wilshire Blvd Ste 201

Los Angeles, CA 90017

(000) 000-0000

TTY: 711

Hours: SA,SU 12AM-12AM, M-F

8AM-6PM

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

90018

Qualicare Pharmacy Services •

3779 S Western Ave # 3779 1/2

Los Angeles, CA 90018

(323) 731-4004

TTY: 711

Hours: SU 12AM-12AM, M-F

9AM-6PM, SA 1PM-5PM

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

90019

Cvs Pharmacy 17749 •

1302 S La Brea Ave Ste A

Los Angeles, CA 90019

(000) 000-0000

TTY: 711

Hours: M-SU 12AM-11:59PM

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

90027

Vons Pharmacy 2665 •

4520 W Sunset Blvd

Los Angeles, CA 90027

(323) 662-2121

TTY: 711

Hours: SA,SU 9AM-5PM, M-F

9AM-9PM

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

90035

Rxall Pharmacy •

1125 S Beverly Dr Ste 100

Los Angeles, CA 90035

(310) 551-2861

TTY: 711

Hours: SA,SU 12AM-12AM,

M-TH 9AM-6PM, F 9AM-5PM

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

90038

Pavilions Pharmacy 2229 •

727 Vine St

Los Angeles, CA 90038

(323) 466-7158

TTY: 711

Hours: SU 10AM-6PM, M-F

9AM-9PM, SA 9AM-5PM

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

90064

Us Precision Pharmacy 10680 •

10680 W Pico Blvd Ste 250

•=This pharmacy supports electronic prescribing.

•= Extended supply of maintenance medications available at this location.

You can go to any of the pharmacies in our network

Interpreting services are available for all providers through Blue Shield Promise Cal Mediconnect Plan at

no cost. An advance notice is needed for face-to- face and ASL interpreting services. To request services,

contact Blue Shield Promise Cal Mediconnect Plan Member Services. If you have questions, please call

Blue Shield Promise Cal Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a

week. The call is free. For more information, visit www.blueshieldca.com/promise/calmediconnect.

This list is subject to change

322

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LOS ANGELES COUNTY PHARMACIES

Los Angeles, CA 90064

(310) 844-0711

TTY: 711

Hours: M,TU,TH,F,SU

12AM-12AM, W 10AM-1PM, SA

12PM-5PM

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

90069

Men's Health Foundation •

9201 W Sunset Blvd Ste G2

Los Angeles, CA 90069

(310) 205-0724

TTY: 711

Hours: SA,SU 12AM-12AM, M-F

9AM-5:30PM

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

LYNWOOD

90262

Apple Rx Pharmacy Store 2 •

3625 Martin Luther King Jr Blvd

Ste 1 Unit 1

Lynwood, CA 90262

(000) 000-0000

TTY: 711

Hours: SU 12AM-12AM, M-F

9AM-6PM, SA 9AM-1PM

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

MISSION HILLS

91345

Cvs Pharmacy 17700 •

10340 Sepulveda Blvd

Mission Hills, CA 91345

(818) 361-1709

TTY: 711

Hours: SU 11AM-5PM, M-F

9AM-7PM, SA 9AM-5PM

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

PICO RIVERA

90660

Better Life Pharmacy (new Life

Pharmacy - Farmacia •

9420 Slauson Ave

Pico Rivera, CA 90660

(562) 222-2020

TTY: 711

Hours: SU 10AM-3PM, M-F

9AM-6PM, SA 9AM-5PM

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

SAN PEDRO

90731

Peninsula Pharmacy 2281 •

1294 W 6th St Ste 100

San Pedro, CA 90731

(310) 833-3535

TTY: 711

Hours: SU 12AM-12AM, M-F

9AM-7PM, SA 10AM-4PM

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

SANTA CLARITA

91387

Vons Pharmacy 3138 •

16550 Soledad Canyon Rd

Santa Clarita, CA 91387

(661) 309-1983

TTY: 711

Hours: SA,SU 9AM-5PM, M-F

8AM-8PM

UPDATE: There was a change

in the provider record;

demographic, phone and/or

•=This pharmacy supports electronic prescribing.

•= Extended supply of maintenance medications available at this location.

You can go to any of the pharmacies in our network

Interpreting services are available for all providers through Blue Shield Promise Cal Mediconnect Plan at

no cost. An advance notice is needed for face-to- face and ASL interpreting services. To request services,

contact Blue Shield Promise Cal Mediconnect Plan Member Services. If you have questions, please call

Blue Shield Promise Cal Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a

week. The call is free. For more information, visit www.blueshieldca.com/promise/calmediconnect.

This list is subject to change

323

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LOS ANGELES COUNTY PHARMACIES

panel status.

TORRANCE

90505

TUJUNGA 91790

SUN VALLEY

91352

Stanfred Drugs •

8031 Vineland Ave

Sun Valley, CA 91352

(818) 767-3737

TTY: 711

Hours: SU 12AM-12AM, M-F

9AM-6PM, SA 9AM-1PM

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

Tormed Pharmacy •

3440 Lomita Blvd Ste 149

Torrance, CA 90505

(310) 326-7706

TTY: 711

Hours: SU 12AM-12AM, M-F

9AM-6:30PM, SA 9AM-1PM

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

91042

Tujunga Pharmacy •

7341 Foothill Blvd # 101

Tujunga, CA 91042

(818) 352-9200

TTY: 711

Hours: SA,SU 12AM-12AM, M-F

9AM-5:30PM

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

VALENCIA

91381

Vons Pharmacy 2030 •

25850 The Old Rd

Valencia, CA 91381

(661) 254-5824

TTY: 711

Hours: SA,SU 9AM-5PM, M-F

9AM-9PM

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

WEST COVINA

Bright Care Pharmacy •

140 N Orange Ave Ste 103

West Covina, CA 91790

(213) 626-5228

TTY: 711

Hours: SA,SU 12AM-12AM, M-F

9AM-6PM

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

WEST HOLLYWOOD

90069

Vons Pharmacy 2739 •

8969 Santa Monica Blvd

West Hollywood, CA 90069

(310) 273-5126

TTY: 711

Hours: SA,SU 9AM-5PM, M-F

8AM-8PM

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

WHITTIER

90603

Vons Pharmacy 2027 •

•=This pharmacy supports electronic prescribing.

•= Extended supply of maintenance medications available at this location.

You can go to any of the pharmacies in our network

Interpreting services are available for all providers through Blue Shield Promise Cal Mediconnect Plan at

no cost. An advance notice is needed for face-to- face and ASL interpreting services. To request services,

contact Blue Shield Promise Cal Mediconnect Plan Member Services. If you have questions, please call

Blue Shield Promise Cal Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a

week. The call is free. For more information, visit www.blueshieldca.com/promise/calmediconnect.

This list is subject to change

324

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LOS ANGELES COUNTY PHARMACIES

15740 La Forge St

Whittier, CA 90603

(562) 943-4288

TTY: 711

Hours: SA,SU 9AM-5PM, M-F

9AM-9PM

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

•=This pharmacy supports electronic prescribing.

•= Extended supply of maintenance medications available at this location.

You can go to any of the pharmacies in our network

Interpreting services are available for all providers through Blue Shield Promise Cal Mediconnect Plan at

no cost. An advance notice is needed for face-to- face and ASL interpreting services. To request services,

contact Blue Shield Promise Cal Mediconnect Plan Member Services. If you have questions, please call

Blue Shield Promise Cal Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a

week. The call is free. For more information, visit www.blueshieldca.com/promise/calmediconnect.

This list is subject to change

325

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LOS ANGELES COUNTY PHARMACIES

LONG-TERM CARE

PHARMACIES

Residents of a long-term care

facility may access their

prescription drugs covered

under Blue Shield Promise Cal

MediConnect Plan through

the facility’s long-term care

pharmacy or another network

long-term care pharmacy.

Blue Shield Promise Cal

MediConnect Plan has a

process in place to assist you

in obtaining prescription drugs

when you are in a long-term

care (LTC) facility. If you are in

an LTC facility and are

prescribed a non-formulary

drug, we will authorize a

one-time, 30-day supply of the

medication prescribed for

transition purposes.

If you are on a complicated

medication regimen, or a

regimen where safety

concerns do not permit you to

be transitioned sooner, up to a

6-month transitional period will

be allowed. This transition

period will also be allowed for

patients with multiple

medications and with multiple

physicians providing care.

For more information, please

call Blue Shield Promise Cal

MediConnect Plan at

1-855-905-3825 (TTY: 711) 8:00

a.m. to 8:00 p.m. seven days a

week.

ARTESIA

90701

Mercy Ltc And Specialty

Pharmacy •

11515 Artesia Blvd

Artesia, CA 90701

(562) 402-0542

TTY: 711

Hours: SA,SU 12AM-12AM, M-F

9AM-6PM

UPDATE: There was a change

in the provider record;

demographic, phone and/or

panel status.

•=This pharmacy supports electronic prescribing.

•= Extended supply of maintenance medications available at this location.

You can go to any of the pharmacies in our network

Interpreting services are available for all providers through Blue Shield Promise Cal Mediconnect Plan at

no cost. An advance notice is needed for face-to- face and ASL interpreting services. To request services,

contact Blue Shield Promise Cal Mediconnect Plan Member Services. If you have questions, please call

Blue Shield Promise Cal Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m. – 8:00 p.m., seven days a

week. The call is free. For more information, visit www.blueshieldca.com/promise/calmediconnect.

This list is subject to change

326

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PROVIDER INDEX

A Abdullatif, Qutayba.... 247, 223

Abjelina, Kenneth ................237

Aguilar, Felix ..............................1

Aguinaldo, Estrella 21, 23, 27,

65, 71, 91, 134

Ahmed, Faisal.........................55

Ahmed, Rabia ........................33

Ahoubim, Daniel ......... 111, 103

Airapetian, Ara.......................62

Akhavan, Parviz................. 84, 1

Al-sarraf, Lena ........................33

Alasil, Tarek 130, 269, 272,

303, 310, 122

Aleman, Edgar .......................30

Aliksanian, Lori ........................53

Allen, Daniel................. 278, 277

Amini, Payam 261, 284, 296,

306, 259

Ammen, Magena ................244

Angelone, Elisa.....................181

Antoun, Cindy ............. 193, 176

Aparicio, Luis...........................33

Arceo, Ruth.............................88

Arcia, John.............. 39, 58, 103

Arkosy, Thomas.....................225

Armani, Robert ............ 211, 180

Arredondo, Alex.......... 283, 265

Atanasio, Joseph .................229

Attento, Adriana ..................229

Avci, Dilek .............................236

Avila, Adriana.......................244

Avitabile, John......................223

B Baez, Maria ...........................199

Baghoumian, Marineh 269, 260

Bansal, Eric ............ 125, 98, 110

Bao, Tien....................... 181, 149

Barba, David...................... 8, 32

Barnett, Chalon....................241

Barr, Mark ................................60

Barrus, Kim.............................221

Barthol, Sara .........................249

Battala, Naga.........................41

Bavarsky, Anita.....................252

Bedrood, Sahar 113, 122, 130,

300, 45, 99, 107

Bei, Ling .................................272

Bejinez-eastman, Ana 109, 2,

21, 23, 25, 88, 91, 10

Benson, Erica ..........................48

Bereliani, Arash................ 11, 10

Bernal, Brenda........................36

Berndes Carlson, Teresita ....225

Bertao, Teresa.........................36

Bharadia, Juma...................... 34

Bhasin, Nitin.............................12

Binder, Robert.... 77, 80, 82, 69

Blakely, David .............. 205, 164

Blueskyes, Roman.................225

Boeckmann, Jessica............272

Booth, Thomas......................253

Bracamontes, Raymond.....160

Brady, Matthew......................53

Brennecke, Bernadette.......248

Bridges, Duane.......................92

Brittain, Debra....................... 240

Brody, Bruce ................ 220, 193

Brody, Dora...........................229

Bui, Tan ..................................150

Burnett, Melissa.....................246

Burns, John..............................62

Butts, Myron ................. 192, 162

Byun, Hayeon .......................201

C Cade, Charlene...................149

Cairnie, Mary 284, 297, 306,

261

Camara, David ........... 306, 297

Campins, Monica ................177

Canabal, Manuel ....... 212, 154

Carella, Joseph ......................28

Caropino, Blake ...................215

Carrillo, Herman ................ 3, 10

Carroll, Joshua...................... 225

Casey, Richard.....................310

Cearfoss, Christine ...............250

Chan, Cheuk Man ...............214

Chang, Andrew .......... 295, 293

Chang, Bogard .. 301, 310, 278

Chang, Chung Young 203,

217, 136

Chang, Guang Di ................214

Chang, Michael .......... 270, 254

Chang, Tom 112, 121, 18, 254,

257, 261, 269, 272, 276, 278,

280, 295, 303, 310, 42, 106

Chanthakaew, Umawan ....193

Chauhan, Bharat .................120

Chen, Brian 269, 273, 279,

302, 42, 45, 257

Chen, David ...................... 61, 2

Chen, Jeng-shiang 203, 217,

136

Chen, Joyce .........................255

Chen, Quincy .............. 195, 194

Chen, Ta Fang......................215

Chen, Tzu-jung......................216

Chen, Yuying ...... 150, 208, 140

Cheng, Ya-wen....................138

Cheung, Eric 111, 12, 127, 22,

24, 26, 31, 39, 6, 98, 106

Cheung, John.............. 206, 175

Cheung, Karen.....................292

Chew, Wesley.......................273

Cho, Eun....................... 178, 168

Choe, Dong..........................153

Choi, Jungsook.....................156

Choi, Ki ..................................151

Choi, Soyoung......................168

Chou, Arthur .................. 96, 117

Christie, Connie ....................182

Chu, Selena 284, 297, 307, 262

Chu, Thomas 114, 125, 47, 94,

100

Chuang, Gina Hua Qin 202,

166

Chuman, Brandon ...............243

Chung Morita, Jonie 147, 184,

139

Chung, Anthony................... 172

Chung, Wanmi .....................169

Ciampa, Christopher .. 295, 294

Claros, John..........................226

Cohen, Jordan .....................214

Corona, Fabian........... 288, 287

Corvino, Neva ......................222

Cruz-schiavone, Gonzalo......60

For more information, please call Blue Shield Promise Cal Mediconnect Plan at 1-855- 905-

3825, (TTY: 711), 8 a.m. to 8 p.m., seven days a week. This list is subject to change.

327

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PROVIDER INDEX Culotta, Anthony 273, 280, 269

D Dalton, Emily ................ 244, 221

Daneshvar, Elenor................221

Dang, Lisa .................... 310, 304

Das, Tara ...................... 182, 175

Dasilva, Antonio ...................187

Davis, Michael 106, 107, 112,

113, 121, 123, 131, 19, 279,

296, 43, 46, 99, 100

Dawson, Jonathan ..............164

De La Pena, William.... 288, 265

De Oliveira, Elizabeth...........133

Deak, Gabi ...........................229

Delshad, George . 112, 41, 104

Diggory, Matthew 284, 297,

307, 262

Discepolo, William........... 57, 34

Djapri, Christine ....................135

Dominguez, Charles ... 288, 265

Doty, Brian.............................155

Du, Elizabeth.........................279

Duan, Deborah 285, 297, 307,

262

Dugan, Jennifer.................... 239

Duong, Henry............... 101, 100

Durrani, Asif .................. 188, 187

Dushenko, Terrance.............240

E Eckel, Gregory................. 51, 49

Eddy-bertrand, Elizabeth 70, 69

Edelstein, Arthur........... 282, 259

Edery, Gabriel.............. 219, 194

Eghbalieh, Sammy 116, 29, 52,

104

Eipl, Kristina............................ 241

Eitan, Nathan..... 22, 26, 4, 110

Ellis, Arnold ................ 74, 84, 67

Eng, Calvin................... 301, 275

Eromo, Ersno ...........................54

Esfahani, Ora ............... 132, 131

Eskilson, Emma......................164

Eubanks, Hayward .................29

Evans, Sanae ........................173

F

Fan, Ting Wen .............. 208, 184

Fass, Tara...............................226

Fatato, Antoinette ...............226

Feng, Charles............... 160, 139

Feygin, Polina .................. 88, 18

Filart, Marcel Adrian 127, 64,

11

Fishberg, Gary ......................294

Floro, Jerry ...............................92

Fong, Richard .............. 205, 196

Fong, Ryan................... 189, 138

Fox-rabinovich, Lola.... 200, 182

Frame, Katherine.................. 153

Frank, Jennifer ......................230

Fruchtbaum, Irene ...............230

Fu, Michael .................. 145, 136

Fu, Rongpin...........................157

G Gabrielian, Karine ....... 316, 305

Gaeta, Yadira ......................245

Galdamez, Luis ......... 84, 91, 18

Gallemore, Ron ...... 13, 44, 129

Ganata, Victor .........................3

Garay, Jose ................. 156, 155

Garcia, Eddie .............. 288, 265

Garcia, Jennifer .......... 181, 171

Garcia, Rachael ..................213

Garg, Bimlesh .......................252

Genato, Sharon............... 72, 65

Gershelis, Anna ....................230

Getting, Michael ..................185

Gilbert, Randall ......................96

Gill, Matthew ............................9

Gin, Jeffrey......................... 86, 1

Goel, Nadia ................. 206, 171

Goldsmith, Steven................226

Goldstein, Estelle ..................251

Goldstone, Alan ...................271

Goldstone, Harvey...............271

Goleh, Shadi .........................206

Gomes, Alex ................ 316, 315

Gomez Falcon, Mariah .......222

Gonzalez, Enrique ......... 98, 109

Goodwin Jr, Lawrence 294, 281

Goring, Christopher ........ 54, 20

Gottlieb, Larry .......................268

Grant-acquah, Kweku 276,

281, 311, 273

Grattan, Anne ............... 59, 311

Grattan, Gil ...........................247

Gravelle, Roxana .................219

Grazer, Sage.........................231

Green, Eugene............ 274, 256

Green, Sari ..............................53

Greener, Michael.................245

Griffin, Daniel ........................210

Griffin, Dominique ................240

Gumbs, Joslyn ........................13

Gutierrez, Andrew....... 212, 182

Gutierrez, Guillermina..............9

H Haas, Bryan...........................185

Hacopians, Sareen ..............245

Hakham, Salar ........................15

Hallbrooks, Landon ..............248

Han, Dong Gwon.................188

Hanna, Gina ...........................41

Hatami, Nazila ......................227

Hea, Jean .............................170

Hean, Sindalisa ......... 76, 81, 67

Hefley, Priscilla ......................241

Heidenfelder, Richard .........251

Heitz, Andrea........................223

Hemans, Nichole..................249

Herta, Kelly ................... 210, 199

Higashi, Randy......................184

Ho, Diep ....................... 185, 142

Ho, Ralph.................................50

Ho, Samuel..............................75

Hogan, James 171, 200, 216,

159

Hoinsky, Michelle..................199

Hong, Donna ........................254

Hong, Sung Hee ...................145

Hong, Zhen-li ................ 208, 157

Hopkins, Adrian ....................250

Hou, Poyuan .........................192

Houser, Natalie .......................90

Hovanesian, Haroutun 317, 305

Hsu, Grace............................255

Hsu, Richard........ 201, 202, 199

Huang, Catherine ................271

For more information, please call Blue Shield Promise Cal Mediconnect Plan at 1-855- 905-

3825, (TTY: 711), 8 a.m. to 8 p.m., seven days a week. This list is subject to change.

328

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PROVIDER INDEX Huang, Jeffrey 285, 298, 307,

262

Huang, Lillian ........................227

Huang, Yung Ju........... 157, 139

Hung, Alex.................... 197, 196

Huo, Wayne ................. 208, 157

Huynh, Anthony....................311

Huynh, Tran ...........................147

Hwee, Jonathan ............. 87, 75

I Ide, Nobuko..........................173

Ifekwunigwe, Christopher ...242

Iskandar, Lucy.......................238

J Jacobs, Bruce.......................154

Jalalat, Parisa .......................311

Javdan, Parviz ..........................6

Jeong, Hoi Jun...................... 197

Jiang, Thomas.........................74

Jing, Ran ...............................195

Jingozian, Vardui..................231

Johnson Boykin, Kim.............231

Johnson, Brock .....................163

Johnson, Jeany ........... 277, 255

Jolly, Cara .............................176

Joukar, Mehrdad ........ 153, 146

Joung, Junkyoung ...............170

Jung, Inho .................... 178, 168

Jung, Ji Hwan .......................151

K Kaiser, William .......................231

Kaplansky, Galina ................232

Kennedy, Devon ......... 114, 101

Keo, Samuel.......................... 239

Khachatryan, Shushanik...... 232

Khachatryan, Tigran ..............30

Khan, Ahmed .........................11

Khan, Ayaz..............................46

Khan, Sadia...........................134

Khanna, Sandeep 44, 6, 99,

13

Khoubian, Anjel ........... 183, 179

Kim, A Young ............... 200, 143

Kim, Chel ...............................170

Kim, Chul Un................. 213, 165

Kim, Daniel ............................151

Kim, Don................................159

Kim, Hye ....................... 181, 177

Kim, Jae................................. 169

Kim, Janet Kiehong..............312

Kim, Melody 261, 276, 279,

296, 302, 254

Kim, Sang Woo .....................142

Kim, Sean ..................................7

Kim, Seog ..............................160

Kim, Stella ..............................315

Kim, William June-ki 166, 171,

152

Kim, Young............................151

Kimia, Roy..............................173

Klamann, Kalina ...................227

Kooklan, Fariba ....................232

Kowalczyk, John 104, 117,

133, 16, 55, 83, 93, 97, 102

Kravchenko, Mayya ... 211, 179

Krinsky Atkins, Leah ..............232

Kwon, Sang Hyeuk ...............150

Kwon, Yeung ........................191

L Lai, Wes .................................184

Lai, Yi-hsien.......... 204, 217, 137

Lao, Jia ..................................302

Larcabal, John .....................288

Latter, Mitchell ............. 305, 257

Laveck, Londa............. 189, 188

Lazzaro, Cynthia.............. 37, 36

Le, Huong..............................312

Lee, Dustin.......................... 7, 15

Lee, Edward............................ 33

Lee, Edwin...............................12

Lee, Hyo ....................... 202, 186

Lee, In Sook.................. 154, 142

Lee, Jae...................................58

Lee, Jason.. 148, 189, 190, 147

Lee, Jay .................................165

Lee, Jin ..................................148

Lee, Jiny ................................183

Lee, Joseph.................. 277, 255

Lee, Judy...............................207

Lee, Kyounghee...................144

Lee, Li Hung ..........................146

Lee, Miran .................... 167, 166

Lee, Sang Wook ...................219

Lee, Sanghyun............. 216, 176

Lee, Scott ..............................312

Lee, Soo............... 150, 175, 141

Lee, Yang-chau .......... 185, 140

Lee, Young............................210

Lee, Yun Soo .........................169

Lee-shim, Eun Seon ..............144

Leonard, Elisa........................233

Lewis, Page...........................237

Li, Jack.......................... 216, 174

Liang, Kristin ..........................224

Liao, David. 114, 123, 125, 104

Liaw, Yih-jenn........................158

Lim, Thomas ................. 116, 115

Lin, Charles................... 209, 158

Lin, Chi-yi ............. 204, 218, 137

Lin, Esther...................... 302, 285

Lin, Hope ...................... 215, 212

Lin, Michael 110, 37, 4, 92,

94, 103

Lin, Steven 162, 165, 204, 218,

137

Lin, Yu-chen ..........................173

Liptawat, Jennifer ................156

Logan, Conor .......................207

Logan, Dwayne.................... 312

Logan, Zena................. 207, 202

Long, Billy...............................143

Long, Mary ............................163

Lorenzo, Keola......................165

Lu, Mei ...................................190

Lu, Yang ....................... 209, 158

Lu, Yong Jun .........................194

Lucasan, Danah Majorie.......36

Luke, Priscilla 285, 298, 307,

263

Ly, Richard ................... 271, 256

M Mahdavi, Paymohn . 44, 46, 43

Mahgerefteh, Shmuel 50, 51,

49

Mahtabifard, Ali ....... 76, 81, 68

Malek, Renia....... 270, 296, 261

Malhotra, Sameer ..................55

For more information, please call Blue Shield Promise Cal Mediconnect Plan at 1-855- 905-

3825, (TTY: 711), 8 a.m. to 8 p.m., seven days a week. This list is subject to change.

329

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PROVIDER INDEX Mandel, Benjamin....... 289, 266

Maria, Aileen ........................316

Marinaro, Thomas ................179

Markle, Susan........................188

Marmureanu, Alexandru 54,

96, 117

Marrin, Bridget ........................35

Marsh, Adrienne.............. 72, 66

Martin, Anthony......................59

Martin, Silvana ......................233

Masaki, Damon ......................40

Mathews, Jane.....................247

Mayberry, Melissa ....... 289, 266

Mchaney, John ....................149

Mckenzie, John ........ 79, 89, 62

Mclafferty, Joel.....................242

Mendonsa, Andrew.............241

Mesrkhani, Razmik................154

Miller, Jaymie........................222

Miller, Pamela .......................190

Miller, Soo ..................... 153, 146

Mishima, Todd 266, 289, 83, 14

Mo, Solomon.........................138

Moayedpardazi, Hamideh 289,

266

Mohebbi, Ali ................ 283, 282

Monroe, Trevor .....................239

Montana Collins, Claudia ...312

Mooney, Andrew .................160

Moore, Lori .......... 298, 308, 259

Morales, Carolina.................190

Morante, Pedro ....................251

Morgan, Michael .................227

Movsessian, Claude.............198

N Najafi, Ali ................... 53, 8, 126

Nalamlieng, Matthew ...........31

Naraghi, Robert................. 8, 17

Nesovic, Slobodan...............240

Nghiem, Janet......................295

Nguyen, Meggie ......... 290, 266

Nguyen, Thien Thu....... 290, 267

Nguyen, Thy ........ 304, 313, 272

Niamehr, Nouriel ....................48

Nikroo, Alireza.............. 220, 178

Nobile, Lucio.................... 42, 41

Nomura, Yoko.......................163

Nourian, Kambiz .......... 194, 180

Novack, Roger .....................125

Ntung, Helen.........................250

O Ochoa, Araceli 285, 298, 308,

263

Odvina, Rheamay ...............144

Oh, Agnes .............................236

Oh, Meesuk.................. 172, 152

Oh, Ruth ................................159

Oh, Se Yeong ..... 166, 172, 152

Ojuri, Adebambo 28, 57, 93,

94, 110

Okie, Theodore... 283, 317, 258

Ong, Olivia. 286, 299, 308, 263

Ordonez, Xavier .......... 317, 264

Orend, Liesel .........................193

Orselli, Rachel .............. 213, 183

P Panoussi, Frank .....................186

Papenhagen, Ted................213

Paramo, Melissa ...................238

Parikh, Gaurav........................ 34

Park, Dae ..............................144

Park, Jae ...................... 179, 168

Park, Jea Young ...................161

Parodi, Jacqueline...............233

Patel, Ankur.............................16

Patel, Jay 263, 286, 299, 308,

259

Patterson, Kala .....................242

Paul, Mariam ........................238

Pazornik, Arthur.....................313

Perez, Alicia ................. 245, 221

Perez, Evelyn.... 267, 290, 7, 14

Perez, Luis ..................... 278, 277

Perlman, Jonathan ..............233

Peters, Joseph ............. 283, 258

Petropoulos, Greg................248

Pham, Cindy .................... 72, 66

Pham, Tung.................. 196, 145

Pham, Vy...................... 313, 304

Philip, Ancil ..............................52

Piccirillo, Vincenzo ...............247

Pine, Stephen .........................40

Pinkerton, Ronald..... 23, 25, 21

Plotkin, Natalia......................203

Poon, Lalita .............................35

Poon, Pak ..............................249

Popalzai, Adeel ......................40

Prieto, Enrique.......................141

Pruthi, Jatinder........................38

Q Quach, Phuc ............... 281, 274

Quach, Sarika.......................174

Quinones, Meisha ................234

R Ramirez, Jessica ...................183

Ramos Montelongo, Flor .....243

Ramos, Enrique................ 71, 65

Reed, Kris...............................224

Reinherz, Ira ................. 212, 174

Ren, Jian-ching ....................189

Renner, Morgan ... 274, 44, 122

Reyes, Adriana .....................222

Rezaei Abbassi, Nima 286, 299,

263

Reznik, Alena ........................128

Reznik, Jacob .......................128

Rhee, Sophia ........................180

Riffel-dalinger, Hugo ..............30

Rivera, Ernest ........................246

Rodriguez, Oscar......... 214, 192

Roe, Richard .................. 19, 129

Roozrokh, Babak ....................39

Rose, Michael ..... 280, 281, 274

Rubinson, William 120, 21, 23,

25, 27, 57, 67, 74, 109

Rubish, Donald .....................234

Ruiz, Jessica ..........................246

Ryu, Hu Ki...................... 186, 167

S Sadrzadeh Rafie, Amir...........30

Saied, Saied............................89

Sako, Manhal........................187

Salado, Maria .......................290

Salib, George............... 290, 267

Saliminejad, Mehrdad...........38

Sanchez, Adriana ....... 291, 267

For more information, please call Blue Shield Promise Cal Mediconnect Plan at 1-855- 905-

3825, (TTY: 711), 8 a.m. to 8 p.m., seven days a week. This list is subject to change.

330

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PROVIDER INDEX Sanchez, Martha..................291

Sanchez, Rodrigo........ 161, 143

Sandberg, Joan ...................240

Sandino, Lisa .........................234

Sandler, Anita .......................234

Santana, Leslie .....................246

Santoro, Michelle ........ 195, 177

Santos-montemayor, Maria 75,

58

Sardin, Divinity ......................243

Sato, Ayaka ..........................313

Saucedo, Ruth......................228

Schwartz, Sarah....................235

Scott, Dana 118, 17, 55, 97,

102

Sczesny, Andrea...................251

Seiden, Rita ...........................244

Seo, Jung Eun .......................174

Seok, Puchun............... 201, 156

Shah, Anoop...........................38

Shah, Kiritkumar....................120

Shah, Krupa ..................... 71, 65

Shammas, Hanna 258, 283,

317, 14

Sharifi, Maryam.......................77

Shaw, Minh 264, 286, 299,

309, 260

Shaw, Ronald........................186

Sheiniuk, Robyn ....................228

Shelton, Raymond 287, 299,

309, 260

Shin, Youn Jung ....................161

Siegel, Gregory............ 217, 147

Sin, Sun...................................169

Slater, Kurt ...............................58

Smaliy, Yuliya ........................191

Soleimani, Massoud ...............59

Son, Jong Soo.............. 167, 159

South Bay Family Health Care -

Redondo Beach...................319

Srisathapat, Amanda ..........141

St Juste, Carlo .............. 205, 143

St. Mary, Gordon......... 252, 223

Steinschriber, Steven..... 45, 282

Stevens, Cynthia ..................235

Stevens, Megan ...................235

Striplin, Donald......................135

Su, Daniel ......................... 45, 31

Suaya, Viviana .....................228

Sugimoto, Jean ........... 293, 292

Suk, Kevin 113, 121, 122, 128,

19, 43, 99, 107

Swearingen, Michael.. 318, 258

T Tabandeh, Homayoun 90, 95,

114

Tabibian, Roya ............ 211, 172

Tai, Liang Yu....................... 86, 2

Tajyar, Amber .............. 195, 149

Talevich, John.......................203

Tama, Maher ..........................38

Tamayo, Robert....................314

Terschluse, Lauren................248

Teshima, Donald ..................314

Thompson, Judy ...................224

Thropay, John 107, 116, 119,

123, 95, 101

Tiu, Kai Fong..........................197

To, Brittany.............................294

Tom, Wesley................. 305, 275

Torres, Judith .........................237

Tran, Dai ....................... 301, 300

Tran, Daniel ............... 28, 88, 10

Tran, Helen ............................256

Tran, Henry . 257, 270, 280, 131

Tran, Jennie 287, 300, 309, 264

Tran, Mailan ..........................314

Tran, Young.......................... 5, 4

Tu, Linh...................................314

Turner, Beckie .........................35

U Uchio, Alejandra ......... 291, 268

Ufano Leon, Jeremee.......... 235

Ung, Susan ................... 292, 268

Uong, Rene...........................162

Urbina, Marvin ................... 9, 86

V Vadrevu, Vijayalakshmi.......131

Varma, Rohit....... 129, 130, 128

Varsani, Poonam..................314

Vigo, Himeno........................219

Villegas, Rex 264, 287, 300,

309, 260

Vlada, Claudiu .......................52

Vu, Hoang.................... 220, 136

W Wainess, Reid 130, 254, 257,

270, 274, 276, 280, 282, 303,

127

Wali, Autar ............ 117, 15, 102

Wang, Chiao-nien 204, 218,

137

Wang, Ping-long ..................197

Wang, Yang................. 209, 163

Watanabe, Dennis...............315

Wells, Trevor ..........................238

Whaite, Sommer...................175

Williams, Carol ......................224

Winston, Mark .............. 306, 293

Wong, Justin .........................249

Wong, Kee ..............................16

Wong, King ...........................304

Wong, Sharon 132, 304, 315,

47, 95, 115

Wong, Thomas............. 209, 140

Woo, Young Uk.....................167

Wood, Ron ............................142

Wright, Don ...........................177

Wright-dohopolski, Brandi ...201

Wu, Bob.....................................5

Wu, Jay.................................. 141

Y Yacoub, Ehab ......................252

Yaghjian, Ara............... 191, 154

Yang, Alan .......... 206, 215, 198

Yang, Catherine.......... 303, 301

Yang, Jor Hwa Lin ................158

Yang, Min Ho ........................170

Yang, Nicole ...........................47

Yao, Chien-kuo ....................198

Yee, Olave............................316

Yeganeh Hajahmadi,

Mahmoud .................... 187, 164

Yeranosian, Michael..............16

Yim, Irene ..................... 277, 256

Yin, Li ......................................146

Yocum, Jacqueline .............228

For more information, please call Blue Shield Promise Cal Mediconnect Plan at 1-855- 905-

3825, (TTY: 711), 8 a.m. to 8 p.m., seven days a week. This list is subject to change.

331

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PROVIDER INDEX Yoo, Carlos................................9

Yoser, Adam .........................179

Yu, Elaine...................... 302, 275

Yu, Kelly ...................................48

Yu, Michael .................... 71, 134

Yu, Yoshimi ............................198

Yulzari, Lee ............................236

Yung, Tin ............................. 86, 3

Z Zarabian, Elham .......... 293, 292

Zarrabi, Cathrine 161, 176, 148

Zhang, Jackie .......................139

Zhao, Ming ............................138

Zwickel, Joseph ........... 218, 210

For more information, please call Blue Shield Promise Cal Mediconnect Plan at 1-855- 905-

3825, (TTY: 711), 8 a.m. to 8 p.m., seven days a week. This list is subject to change.

332

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PHARMACY INDEX

A Apple Rx Pharmacy Store 2

323

B Bell Gardens Family Pharmacy

1 ....................................... 320

Better Life Pharmacy (new Life

Pharmacy - Farmacia ... 323

Bright Care Pharmacy... 324

C Cvs Pharmacy 11028 ..... 322

Cvs Pharmacy 17700 ..... 323

Cvs Pharmacy 17749 ..... 322

E East Valley Pmq Covina

Pharmacy ....................... 320

Encino Care Pharmacy. 321

G Glendale West Pharmacy 321

Good Samaritan Total Care

Pharmacy ....................... 322

H Health Mart Midway...... 320

I I And G Pharmacy Inc... 321

M Men's Health Foundation323

Mercy Ltc And Specialty

Pharmacy ....................... 320,

326

P Pacific Plaza Pharmacy

5624266588 ..................... 321

Pavilions Pharmacy 2212 320

Pavilions Pharmacy 2214 320

Pavilions Pharmacy 2229 322

Peninsula Pharmacy 2281 323

Q Qualicare Pharmacy Services

322

R Remedy Drugs ................ 321

Rosa 1 Pharmacy 2547.. 320

Rxall Pharmacy............... 322

S Stanfred Drugs................ 324

T Tormed Pharmacy ......... 324

Tujunga Pharmacy......... 324

U Us Precision Pharmacy 10680

322

V Vons Pharmacy 1625..... 321

Vons Pharmacy 2027..... 324

Vons Pharmacy 2030..... 324

Vons Pharmacy 2665..... 322

Vons Pharmacy 2739..... 324

Vons Pharmacy 3138..... 323

For more information, please call Blue Shield Promise Cal Mediconnect Plan at 1-855- 905-

3825, (TTY: 711), 8 a.m. to 8 p.m., seven days a week. This list is subject to change.

333

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Page 340: MAR VI Accepted Date 2020 - Blue Shield of California€¦ · HEALTHCARE PARTNERS IPA - SO BAY Bác sĩ chăm sóc chính .....71 Chuyên gia .....72 HEALTHCARE PARTNERS IPA-TALBERT

DIR0148-AD-LA-VI (03/20)