Medi-Cal Suspended and Ineligible Provider List (susp...
Transcript of Medi-Cal Suspended and Ineligible Provider List (susp...
susp AMedi-Cal Suspended and Ineligible Provider List 1
Physician ProviderNumber
Aaron, Deborah Lyn G70081 Suspended c/o Southeast Surgical indefinitely effective Center 08/21/03.3100 Tongass AvenueKetchikan, Alaska and900 Kiely BoulevardSanta Clara, California
Abeyatunge, Lambert A38300 Suspended1180 North Indian Canyon indefinitely effective Drive, Suite #E218 6/25/04.Palm Springs, California and1695 North Sunrise WayPalm Springs, California
Abdel-Aziz, Mohamed I. A37224 Suspended2107 Isle of Palms Drive indefinitely effectiveValrico, Florida 9/16/04.
Abu-Assal, Maged L G50849 Suspended11346 Mountain View indefinitely effective Avenue, Suite # A 11/28/05.Loma Linda, California
Abuelkhair, Ayda W. A47976 Suspended dba: Clinica Metropolitana indefinitely effective856 North Edgemont Street 01/19/04.Los Angeles, California or14435 Hamlin Street, Suite 203Van Nuys, California or7965 Sierra Avenue, Suite LFontana, California or958 N. Vermont AvenueLos Angeles, California
Abuzeni, Patrick Ziad A63503 Suspended260 Crandon Boulevard, indefinitely effectiveSuite 32-97 6/10/02.Key Biscayne, Florida
Aden, Gary C., M.D. 00C266440 Suspended2333 1st Avenue indefinitely effectiveSan Diego, California 10/9/89.
Adler, Stephen C. G17393 Suspended3441 52nd Street indefinitely effectiveMoline, Illinois 4/26/04.
Adiong, Thelma Roble 00A397820-22 Suspended577 Southerland indefinitely effectiveStockton, California 06/21/00.
Aengst, Fred C26434 Suspended375 Hungtington Drive, indefinitely effectiveSuite #E 10/9/04.San Marino, California and1060 East Green StreetPasadena, California and801 North Tustin Avenue, #202Santa Ana, California
Physician ProviderNumber
Agbebiyi, Jonathan, M.D. SuspendedP.O. Box 181298 indefinitely effectiveCorpus Christi, Texas 4/23/96.
Agee, Douglas Moore 28581 Suspended2120 Fairview indefinitely effectiveRiverside, California 3/30/2007.
Agee, Lawrence Carter, G59995 Suspended M.D. indefinitely effective3288 Bell Road 2/20/2001.Auburn, California
Aguilar, Christopher 83131 Suspended900 S. Fairmont Avenue indefinitely effectiveLodi, California 6/19/2007. and1651 Lander Avenue, #90Turlock, California
Aguilar, Delores 00A227620 Suspended800 West 1st Street, #710 indefinitely effectiveLos Angeles, California 7/1/94.
Aguiluz, Amable A33886 Suspended De Los Reyes, Jr. indefinitely effective13330 Bloomfield Avenue, 07/07/04.Suite 111Norwalk, California and21530 Pioneer BoulevardHawaiian Gardens, California and21500 Pioneer Boulevard,Suite 108Hawaiian Gardens, California
Ahles, Peter C29552 Suspended3340 West Ball Road, indefinitely effectiveSuite #C 2/24/2006.Anaheim, California and628 East San Antonio DriveLong Beach, California and936 Atlantic AvenueLong Beach, California
Ahmadi, Manocher 00A264770-1 Suspended aka: Kiana Ahmadie indefinitely effectiveP.O. Box 14665-343 01/27/00.Tehran, Iran
Akpulonu, Lawson 00A319170 Suspended3841 W. Washington indefinitely effective Boulevard 8/20/92.Los Angeles, California
Alavi, Nasser 51905 Suspended5565 Grossmont Center indefinitely effective Drive, #1 6/20/2007.La Mesa, California and6530 Linda LaneSan Diego, California
Al-Bussam, Nazar, M.D. A26479 Suspended11411 Brookshire Avenue, indefinitely effectiveSuite 503 02/07/02.Downey, California
1 – Medi-Cal Suspended and Ineligible Provider ListOctober 2007
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Physician ProviderNumber
Albert, Samuel H. G18039 Suspended10840 Warner Avenue, indefinitely effectiveSuite #109 9/17/05.Fountain Valley, California and1203 Cabrillo Park DriveSanta Ana, California
Alexander, Merrill J. 00C161290 Suspended801 17th Street, Suite B CGP022075 indefinitely effectiveModesto, California 11/27/91.
Alexander, William 00G145450 Suspended1725 Vistazo West 00G145451 indefinitely effectiveTiburon, California 5/1/01.
Alfano, Jose Angel C41291 Suspended 2nd General Hospital indefinitely effectiveCMR 402 Box 1587 7/16/01.APO, AE 09180
Alfred, Joseph Tyrone C24472 Suspended767 Albertani Street indefinitely effectiveCarson, California 08/20/03. or5260 S. Figueroa Street, Suite 114Los Angeles, California
Ali, Salah T., M.D. 00A177060 Suspended14102 South Pioneer 00A177061 indefinitely effective Boulevard 11/28/80.Norwalk, California
Allen, Harold J., Jr. 00A207930 Suspended265 San Marcos Trail indefinitely effectiveSanta Fe, New Mexico 2/28/97.
Allevi, Joseph Thomas 00C431430 Suspended25658 Pasco La Ciesta indefinitely effectiveLaguna Niguel, California 08/29/00.
Alliegro, Anselmo M. C38447 Suspended633 North Central Avenue, indefinitely effective#105 12/14/2006.Glendale, California and4056 Orange AvenueLong Beach, California and1155 North Vermont Avenue,Suite #203Los Angeles, California
Allison, Ralph B. 000G42110 Suspended2162 Mountain View Drive ZZZ45594Z indefinitely effectiveLos Osos, California 5/20/99.
Alpern, Gary M. G25029 Suspended2412 Ponderosa Drive, indefinitely effectiveSuite B-103 2/13/02.Camarillo, California
Alston, Adrienne Theresa G44804 Suspended118 South Mansfield indefinitely effective Avenue 2/14/2007.Los Angeles, California and3640 Lomita Boulevard,Suite #304Torrance, California
Physician ProviderNumber
Alston, Warren Webster G61467 Suspended1348 Congress Street indefinitely effectiveSan Bernardino, California 3/2/01.
Althouse, Ivan G. CFE29848 SuspendedP.O. Box 3658 indefinitely effectiveNapa, California 1/29/02.
Alwan, Mouhanad Mark A44569 Suspended aka: Alwan, M. Mark indefinitely effective2508 North Mountain Avenue 05/15/03.Claremont, California
Alway, Paul R. 00G474151 Suspended1111 San Antonio Avenue CGP145015 indefinitely effectiveAlameda, California 8/20/98.
Amir-Jahed, Abasali A41879 Suspended439 N. Doheny Drive, #207 indefinitely effectiveBeverly Hills, California 9/9/02.
Amsden, Neal F. 15208 Suspended28 N. Vista de Catalina indefinitely effectiveLaguna Beach, California 3/26/2007.
Anaya, Javier Meda SuspendedCalle Vincente Guerrero 2019 indefinitely effectiveTijuana, Baja California 09/20/00.
Anderson, Angela Suspended23314 Marigold Street, Suite 202 indefinitely effectiveTorrance, California 8/12/96.
Anderson, Athur, M.D. 00C245380 Suspended10 Eastmont Mall 00C245381 indefinitely effectiveOakland, California 9/30/82.
Anderson, Donna Marie G57332 Suspended aka: Burns Anderson, indefinitely effective Donna Marie 2/26/02.1370 RosecransSan Diego, California
Anderson, Gerlad Marvin 00A216340 Suspended3565 Linden Avenue, indefinitely effectiveCondo #165 03/29/00.Long Beach, California
Anderson, Gordon H., M.D. 000G24990 Suspended260 Locust Street indefinitely effectiveSanta Cruz, California 3/21/74.
Anderson, Kevin P. G59003 Suspended2750 E. Washington indefinitely effective Boulevard, #360 11/29/99.Pasadena, California
Anderson, Michael O. 00G151850 Suspended26811 Shorewood Road indefinitely effectiveRancho Palos Verdes, California 04/24/00.
Andrade, Sergio A25096 Suspended dba: San Rafael Medical Center indefinitely effective308 Starlane Drive 3/12/01.La Canada, California
Ang, Eriberto C. Jr. A42030 Suspended4195 Chino Hills Parkway, SA27432 indefinitely effective#358 10/1/02.Chino Hills, California
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Physician ProviderNumber
Angel Jr., David L. A71316 Suspended520 University Avenue, Suite 2 indefinitely effectiveLos Gatos, California 7/20/01.
Angtuaco, Ernesto Virgilio A37196 Suspended3635 Sugarbush Drive indefinitely effectiveCanfield, Ohio 06/06/03.
Anspach, Paul 00A121980 Suspended700 17th Street indefinitely effectiveModesto, California 4/23/92.
Anthony, Jerry B. Physician SuspendedP.O. Box 4253 Assistant indefinitely effectiveYuma, Arizona 2/22/96.
Anthony, Neville N., M.D. 00A353020 Suspended3990 University Avenue 00A353021 indefinitely effectiveRiverside, California 4/2/85.
Antonsson, Karin A. 00A401120 Suspended aka: Anna K. Antonsson indefinitely effective1650 Jackson Street, #801 12/20/99.San Francisco, California
Apablasa, Robert J., M.D. 000G45870 Suspended4513 E. Compton Boulevard indefinitely effectiveCompton, California 9/24/79.
Appleman, Walter A20067 Suspended1534 Shenandoah Street, #9 indefinitely effectiveLos Angeles, California 06/30/03.
Aram, Davar 00A463920 Suspended2376 Gypsum Court 00A463921 5/20/99Chino Hills, California for 10 years.
Arana, Edward, M.D. Suspended107 Quien Sabe indefinitely effectiveCarmel Valley, California 1/4/89.
Arfania, Jamshid J. 00A257550 Suspended955 Deep Valley Drive, 00A257551 indefinitely effectiveP.O. Box 3117 00A257752 6/15/01.Palos Verdes, California
Arnett, Donald, M.D. 00C227190 Suspended638 W. Duarte Road, #3 ZZZ75069Z indefinitely effectiveArcadia, California 3/6/89.
Arterberry, John D. A17895 Suspended7180 Mohawk Trail indefinitely effectiveYucca Valley, California 4/1/2005.
Asad, Younis 00A316030 SuspendedP.O. Box 8628 indefinitely effectiveToledo, Ohio 3/10/95.
Asbury, Stanley E., D.O. 020A33630 Suspended431 South C Street indefinitely effectiveOxnard, California 5/30/91.
Ashokan, Annamalai A43142 Suspended947 Cass Street, Suite 1 indefinitely effectiveMonterey, California 9/24/01.
Assad, Hany Y. A54309 Suspended130 Market Place, Suite 125 indefinitely effectiveSan Ramon, California 1/22/02.
Physician ProviderNumber
Ataee, Shahab Suspended20 Lighthouse Point indefinitely effectiveAliso Viejo, California 4/20/04.
Avelar, Susana Suspended2010 Pacific Avenue, #7 indefinitely effectiveSan Francisco, California 2/4/97.
Aybar, Randall I, M.D. Suspended296 Fawn Valley Court indefinitely effectiveSimi Valley, California 1/23/2007. and1125 South Beverly Drive,Suite #610Los Angeles, California
Ayers, Jerry Daniel 00A427930-31 Suspended255 Elm Street, Suite 105 indefinitely effectiveEscondido, California 09/20/00.
Ayers, Jerry D. A42793 Suspended1260 Via Rancho Parkway indefinitely effectiveEscondido, California 7/6/2006. and2001 4th AvenueSan Diego, California
Ayres, William Hamilton 8492 Suspended153 N. San Mateo Drive, indefinitely effective#409 4/11/2007.San Mateo, California
Babad, Tova L. G28761 SuspendedCentinela Medical Group indefinitely effective933-B North Centinela Avenue 12/16/99.Inglegood, California
Babcock, Bruce D. 00C159070 Suspended1026 Oak Grove Road indefinitely effectiveConcord, California 4/18/96.
Bahou, Kamil Emil 00A294280 Suspended527 9th Street 00A294281 indefinitely effectiveHuntington Beach, California 8/20/98.
Bailey, Todd, M.D. 00A150691 Suspended2701 Atlantic Avenue indefinitely effectiveLong Beach, California 4/25/91.
Bain, Martin F., M.D. 00C192910 Suspended2406 Torrance Boulevard indefinitely effectiveTorrance, California 6/14/90.
Baird, Clara M. 00A076660 Suspended170 E. 2nd Avenue indefinitely effectiveChico, California 12/31/86.
1 – Medi-Cal Suspended and Ineligible Provider ListOctober 2007
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Physician ProviderNumber
Baird, Curtis J. G75160 Suspended12431 Windsor Drive indefinitely effectiveYucaipa, California 3/20/02.
Bajwa, Ahsan Kalim A40641 Suspended6085 North First Street, indefinitely effectiveSuite 102 05/02/03.Fresno, California
Baker, Herbert M. XPY026180 Suspended258 The Boulevard indefinitely effectiveEden, California 6/2/95.
Balette, Robert E. A48109 Suspended2007 Wilshire Boulevard, indefinitely effective#307Los Angeles, California 7/18/01.
Ball, Craig J. G38467 Suspended73 180 El Paseo indefinitely effectivePalm Desert, California 09/02/03. and 1720 Cesar Chavez,Suite 1514Los Angeles, California and 4644 Lincoln Boulevard, Suite 414Marina Del Rey, California
Ballard, William R. 00A106780 Suspended12556 Daisy Avenue 00A206781 indefinitely effectiveBoron, California 00A206782 5/3/86.
Ballesteros, Jose 00A363560 Suspended aka: Ballesteros, 00A363561 9/20/99 Jose Sayson for 25 years.16539 Brass Lantern DriveLa Mirada, California
Balmes, Ruben Suspended1544 N. El Camino Drive indefinitely effectiveTempe, Arizona 9/11/95.
Balogh, Laszlo A46588 Suspended132 West Broadway, #333 indefinitely effectiveSan Diego, California 9/18/97.
Balourdas, Gregory M. G51351 Suspended4101 Randolph Street indefinitely effectiveSan Diego, California 9/20/01.
Baltierra, Juan R. PA10073 SuspendedP.O. Box 1134 Physician 3/18/99Soledad, California Assistant for 5 years.
Bandlow, Betty Rose 00C231750 Suspended3645 Buchanan Street, indefinitely effectiveApartment #203 06/07/00.San Francisco, California
Banker, Deborah Ellen G39808 Suspended23852 Pacific Coast Highway, indefinitely effectiveSuite 342 07/27/98.Malibu, California and22653 Pacific Coast HighwayMalibu, California
Physician ProviderNumber
Banoff, Harry, M.D. 00A126170 Suspended4042 Villa Vera indefinitely effectivePalo Alto, California 7/27/95.
Baraque, Ivan D. A43144 Suspended77-18 141 Street, Apt. B indefinitely effectiveKew Garden Hills, New York 07/12/01.
Barcan, Andrew M. GFE23055 Suspended2624 Velarde Drive indefinitely effectiveThousand Oaks, California 3/26/02.
Bardolph, Thomas Richard G47656 Suspended5918 Ocean Terrace Drive indefinitely effectiveRancho Palos Verdes, California 9/24/02.
Barkal, Paul Kevin A44292 SuspendedP.O. Box 370173 indefinitely effectiveSan Diego, California 1/13/2005.
Barnes, James Keith G35108 Suspended1820 South Escondido indefinitely effective Boulevard, Suite #201 10/21/04.Escondido, California
Barnes, John B. Jr., M.D. 00G043007 Suspended2516 W. Santa Barbara indefinitely effective Avenue 9/2/90.Los Angeles, California
Barnett, Cleophas, D.O. 020A30430 Suspended dba: West Alondra 020A30431 indefinitely effective Medical Group ZZZ72798Z 2/14/78.1410 West Alondra BoulevardCompton, California
Baroud, Khalil S. A60738 Suspended62016 Paso Robles indefinitely effective Highway 10/20/04.Lost Hills, California
Barquin, Otto Pedro Suspended7562 Ellis Avenue, Apt. B2 indefinitely effectiveHuntington Beach, California 7/18/96.
Barr, Eddie 00A125850 Suspended2420 N. California Street, Rm. 1 indefinitely effectiveStockton, California 10/21/94.
Barranco, Charles J., M.D. 00C325120 Suspended13083 Caminito Point indefinitely effectiveDel Mar, California 8/28/91.
Barrett, Thomas Michael A26556 Suspended17497 Main Street indefinitely effectiveHesperia, California 4/7/03.
Barry, Patrick Suspended2818 Dusk Drive indefinitely effectiveSan Diego, California 12/19/95.
Bartschi, Larry 00A261500 Suspended4444 Bell Road, A indefinitely effectiveChico, California 1/27/99.
Bass, Howard R. 39193 Suspended2136 West 31st Street indefinitely effectiveLos Angeles, California 3/23/2007.
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Physician ProviderNumber
Battalino, Barbara 00AX43610 Suspended2000 Los Osos Valley Road indefinitely effectiveLos Osos, California 10/19/00.
Battiste, Aldo Anthony Jr. G74537 Suspended14 Deer Run Trail indefinitely effectiveLawton, Oklahoma 10/29/02.
Bauder, George B. 00C198120 Suspended2470 Quincy Road indefinitely effectiveOroville, California 5/10/96.
Bauer, Charles Donald 00G341370 SuspendedP.O. Box 5315 indefinitely effectiveSalinas, California 6/17/99.
Bauer, Henry Paul, Jr. C29692 Suspended7339 El Cajon indefinitely effective Boulevard, H 3/1/2005.La Mesa, California and8575 Gibbs Drive, Suite #110San Diego, California
Baughman, John A. 00A284220 Suspended3225 E. Carson Street indefinitely effectiveLakewood, California 5/13/92.
Baughman, John A. 020A23650 Suspended1701 Palm Canyon Road indefinitely effectivePalm Springs, California 5/13/92.
Baughman, John A. 020A23651 Suspended8912 W. Katella Avenue, indefinitely effectiveSuite G 5/13/92.Anaheim, California
Baumzweiger-Bauer, G19134 SuspendedWilliam E. indefinitely effective18375 Ventura Boulevard, 9/6/02.#513Tarzana, California
Bayham, Wilbur C. G2179 Suspended6320 N.27th Avenue, indefinitely effectiveSuite B 3/25/02.Phoenix, Arizona
Bayless, James M. 00C276490 Suspended 3940 Chapman Place indefinitely effectiveRiverside, California 2/19/98.
Bedney, Donald L., M.D. 38955 SuspendedP.O. Box 1762 indefinitely effectiveLoma Linda, California 8/7/2007.
Belford, Paul D. 32146 Suspended13631 W. Banff Lane indefinitely effectiveSurprise, Arizona 6/1/2006.
Belk, Donald, M.D. 000G77990 Suspended15525 Pomerado Road 000G77991 indefinitely effectivePoway, California 7/16/83.
Bell, Carl F., M.D. 00C285300 Suspended401 South Shamrock 00C285301 indefinitely effective Avenue 2/4/82.Monrovia, California
Physician ProviderNumber
Bell, Ralph Sheldon G7465 Suspended1138 Crystal Drive indefinitely effectivePalm Beach, Florida 06/30/03.
Bell, Wallas Newton G32181 Suspended110 Third Street, indefinitely effectiveSuite 340 3/4/04.Henderson, Kentucky
Bendall, Sherry Ann Family Care GR0047440-1 Suspended Medical Group 00AX49940 indefinitely effective20 Aspen Creek Lane 20A4994 05/18/00.Laguna Hills, California
Benfatto, Frank, Jr. 00G299970 Suspended1830 Earhart Court indefinitely effectiveOxnard, California 02/20/00.
Benson, David M. Suspended1470 Montgomery Street indefinitely effectiveSan Francisco, California 07/20/00.
Beranek, Steven Ray GFE66025 Suspended406 Cedar Drive indefinitely effectiveEnterprise, Alabama 6/11/02.
Bergin, Patrick John G60143 Suspended1794 Sweetbriar Lane indefinitely effectiveEugene, Oregon 9/28/04.
Bergsrud, Richard A., M.D. 00G210110 Suspended 6024124 Lyons Avenue days effectiveNewhall, California 8/29/91.
Berjis, Parviz A42538 Suspended11645 Wilshire Boulevard, indefinitely effectiveSuite #909 6/12/2006.Los Angeles, California
Berlin, Stuart Mark, M.D. 00G487560 Suspended31926 Watergate Court indefinitely effectiveWestlake, California 9/14/95.
Berlow, Rustin R. G76945 Suspended5190 Governor Drive, Apt 101 indefinitely effectiveSan Diego, California 9/20/01.
Berman, Marshall L. G22551 Suspended9046 Vista Grande indefinitely effectiveLos Angeles, California 11/5/01.
Bertleson, Douglas E. G42625 Suspended801 East Mountain View Street, indefinitely effectiveSuite #C 12/6/04.Barstow, California
Beverly, Clarence E., M.D. C24110 Suspended8207 Orchard Point Road indefinitely effectivePasadena, California 6/27/91.
Bhatt, Kiran 00A349060 Suspended1364 N. Schooner Lane CGP077605 indefinitely effectiveAnaheim, California 7/20/99.
1 – Medi-Cal Suspended and Ineligible Provider ListSeptember 2007
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Physician ProviderNumber
Bhaskara, Nagaraja G. A36798 Suspended1600 West Avenue, indefinitely effective Suite #J 11/30/04. and44900 60th Street, WestLancaster, California
Biava, Floyd K., M.D. Suspended dba: Meridian Clinic 5 years effective48 Hillbrook Drive 12/8/88.Portola Valley, California
Bigelsen, Harvey AZ-MD09667 Suspended710 Whiting Court 4/20/98San Diego, California for 5 years.
Bilder, Paul Andre XPY009390 Suspended1813 West Harvard Avenue, indefinitely effectiveSuite 214 04/03/00.Roseburg, Oregon
Birds, Valentine G. 00A286950 Suspended12626 Riverside Drive, #510 indefinitely effectiveNorth Hollywood, California 12/19/91.
Birkmeyer, Christopher 00G534722 Suspended371 E. Bullard, Suite 104 indefinitely effectiveFresno, California 3/7/92.
Birkmeyer, Christopher 00G534720 Suspended18552 Macarthur Boulevard indefinitely effectiveIrvine, California 3/7/92.
Birkmeyer, Christopher 00G534721 Suspended12440 E. Firestone indefinitely effective Boulevard, Suite 101 3/7/92.Norwalk, California
Bittar, David Albert 39510 Suspended3626 Ruffin Road, indefinitely effectiveP.O. Box 82807 8/12/04.San Diego, California
Black, Murray L. 00A288620 Suspended609 S. 48th Avenue indefinitely effectiveYakima, Washington 8/27/96.
Blair, Richard A. C26082 Suspended150 Garden Lane indefinitely effectiveColumbia, Kentucky 06/13/03.
Blake, Donald K., Jr. 00A212820 Suspended6370 Meadow Glen Place indefinitely effectiveRancho Cucamonga, California 12/20/99.
Blake, George, M.D. 00G124290 Suspended17822 Beach Street, indefinitely effective#136 8/14/81.Huntington Beach, California
Blakely, George Wayman 00A308510 Suspended924 Buena Vista Street, 00A308511 indefinitely effectiveSuite 204 5/30/97.Duarte, California
Blakewood, Robert 00C282870 Suspended16 Yolanda Drive indefinitely effectiveSan Anselmo, California 10/11/95.
Physician ProviderNumber
Blanchard, Phillip Briar G51137 SuspendedP.O. Box 15065 indefinitely effectiveLong Beach, California 1/24/2006. and2089 Vale Road, Suite #23San Pablo, California
Blasquez, Jaime, M.D. 00A218430 Suspended525 West Center indefinitely effectiveVisalia, California 8/14/83.
Blee, James Alicante 23208 SuspendedP.O. Box 383 indefinitely effectiveHighland, California 8/1/2006.
Blitz, Arie 00G789730 Suspended c/o 1310 West Stewart indefinitely effective Drive, Suite 503 09/20/00.Orange, California
Blodgett, John R. G6431 Suspended42335 50th Street West, indefinitely effectiveSuite #105 8/9/2005.Quartz Hill, California
Bloomfield, Harold G18886 Suspended Herman indefinitely effective1110 Luneta Drive 12/21/01.Del Mar, California
Blount, James J. SuspendedP.O. Box 11136 indefinitely effectiveSan Bernardino, California 11/9/94.
Boal, Christopher 00A233330 Suspended21 Miramonte Road indefinitely effectiveCarmel Valley, California 12/29/95.
Bohee, Sumner T. C17942 Suspended aka: Sheen, John D. indefinitely effective Lu, Diana 5/7/2007.5944 Avalon BoulevardLos Angeles, California and9461 Grindlay Street,Suite #102Cypress, California and5807 Avalon Boulevard, Suite #103Los Angeles, California
Bolles, Leo Joseph Suspended15611 Bellevue Redmond Road indefinitely effectiveBellevue, Washington 3/18/99.
Bond, Walter D. Suspended5170 N. Sepulveda Boulevard indefinitely effectiveSherman Oaks, California 2/12/95.
Bone, William D. GFE63153 Suspended801 East 6th Street, #604 indefinitely effectivePanama City, Florida 11/27/01.
Boone, John O. 000G26820 Suspended509 S. Smith Street indefinitely effectiveCorona, California 9/7/87.
1 – Medi-Cal Suspended and Ineligible Provider ListSeptember 2007
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Physician ProviderNumber
Boonsurmsuwongse, 00A377200 Suspended 60Bungom days effective101 Adkisson Way 3/9/91.Taft, California
Borden, Larry 00C317100 Suspended5055 E. Anaheim Street 00C317101 indefinitely effectiveLong Beach, California 2/23/95.
Bores, Leo Daniel C39943 Suspended12475 North 126th Street indefinitely effectiveScottsdale, Arizona 8/31/04.
Bors, John G. G77363 Suspended2360 Clay Street indefinitely effectiveSan Francisco, California 7/6/2005.
Bowen, Cecil D., Jr. 00G666330 Suspended242 9th Street indefinitely effectiveBlythe, California 8/20/01.
Bowes, Robert Royal 00A250600 Suspended aka: Robert R. Bowes indefinitely effective1319 South Broadway, 6/18/98.Suite 2Santa Ana, California
Boyce, Daniel J. A23178 Suspended1514 North Sycamore indefinitely effective Street 3/2/2006.Santa Ana, California and805 West La Veta Avenue,Suite #104Orange, California
Bradley, Bruce E. 12062 Suspended1555 Mirasol Drive indefinitely effectiveSan Marino, California 9/15/2006.
Bradley, Vincent D. 00G210250 Suspended337 El Camino Real, indefinitely effectiveSuite 306 2/4/94.Encinitas, California
Braemer, Nicholas G. 00A219270 Suspended3400 Lomita Boulevard, 00A219271 indefinitely effective#301 00A219272 1/20/95.Torrance, California 00A219273
00A21927400A21927500A21927600A21927700A21927800A219279
Branson, Donald E. 00C195010 Suspended 60P.O. Box 10 days effectiveLaveta, Colorado 5/13/92.
Braun, Robert 00A452520-2 Suspended 171 South Vista Street 06/15/00 Los Angeles, California for 5 years.
Brayshaw, Nora SuspendedP.O. Box 620551 indefinitely effectiveWoodside, California 11/20/97.
Breedlove, David L. 00AX50970 Suspended700 E. Ocean Boulevard, indefinitely effectiveUnit 2807 1/5/97.Long Beach, California
Physician ProviderNumber
Brennan, Patrick F., M.D. Suspended 603234 Hermosa Avenue days effectiveHermosa Beach, California 3/9/91.
Breslaw, Leonard 00C172290 Suspended1828 S. Western Avenue 00C172291 indefinitely effectiveLos Angeles, California 7/28/88.
Breslaw, Leonard 00C172290 Suspended15910 Ventura Boulevard, 00C172291 indefinitely effective#1100 7/28/88.Encino, California
Breslow, Alan 000G81130 Suspended5861 Marion Court 000G81131 indefinitely effectiveEl Sobrante, California 8/17/96.
Brewster, Floyd Michael A20268 Suspended400 Wovenwood indefinitely effectiveOrinda, California 06/09/03. and3301 Clayton RoadConcord, California
Brezel, Bruce S. MD26384 SuspendedP.O. Box P indefinitely effectiveShelton, Washington 7/20/98.
Bright, Robert C., Jr. 63567 Suspended70 Grace Terrace indefinitely effectivePasadena, California 3/16/2007.
Brilliant, Lee 00G332180 Suspended 309375 San Fernando Road days effectiveSun Valley, California 1/10/92.
Brindle, Fred Andrew G42843 Suspended3006 Campbell Street, #2 indefinitely effectiveSandusky, Ohio 07/20/03. and2015 Clarmar Way, #4San Jose, California
Bristo, Lionel D. G32500 Suspended3019 Olympic View Drive indefinitely effectiveChino Hills, California 4/13/02.
Brode, Earle I., M.D. 000C67130 Suspended3330 3rd Avenue indefinitely effectiveSan Diego, California 1/3/89.
Brodhead, Charles L., Jr. 00C264360 Suspended4275 Lemon Street, indefinitely effectiveSuite 101 2/20/98.Riverside, California
Brodie, Howard R. 00G449300 Suspended5912 Cahill Avenue indefinitely effectiveTarzana, California 9/20/99.
Brown, Albert K. 00A301030 Suspended2010 Wilshire Boulevard, 00A301031 indefinitely effectiveSuite 610 00A301032 12/20/99.Los Angeles, California
Brown, Ian Steven 00G296400 Suspended465 N. Roxbury Drive, 00G296401 indefinitely effectiveSuite 10 CGP041801 8/15/95.Beverly Hills, California
1 – Medi-Cal Suspended and Ineligible Provider ListSeptember 2007
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Number
Brown, John R., M.D. 00A130321 Suspended2080 Century Park East, #4 indefinitely effectiveLos Angeles, California 12/20/77.
Brown, Jonel L., II 00C248810 Suspended5074 Paces Station Road indefinitely effectiveAtlanta, Georgia 9/18/96.
Brown, Michael G. A42729 Suspended17070 Red Oak, Suite 101 indefinitely effectiveHouston, Texas 01/16/04.
Brown-Ornish, Shirley C41571 Suspended Elizabeth indefinitely effective aka: Brown, Shirley Elizabeth 03/28/02.7 Miller AvenueSausalito, California
Brown, Richard F. 000G56840 Suspended17 S. Fifth Street Mall indefinitely effectiveRedlands, California 8/18/93.
Brown, Shirley Elizabeth C41571 Suspended aka: Brown-Ornish, indefinitely effective Shirley Elizabeth 3/28/02.7 Miller AvenueSausalito, California
Browning, Ellis V. A10413 Suspended1150 West 24th Street, indefinitely effectiveSuite F 2/17/00.Yuma, Arizona
Bruder, Murray Louis G53184 Suspended2161 Sagecrest Avenue indefinitely effectiveLas Bruces, New Mexico 05/04/00.
Bruning, Jeffrey Lee 00G395860 Suspended510 A Cypress Avenue indefinitely effectiveFort Bragg, California 2/18/99.
Brunjes, Shannon D. A16297 Suspended1712 E. Midwick Drive indefinitely effectiveAltadena, California 10/10/02.
Bryce, William A28255 Suspended400 North San Gabriel indefinitely effective Avenue 12/17/2004.Azusa, California
Buchanan, Lee K. 00C375700 SuspendedP.O. Box 3660 indefinitely effectiveRed Lodge, Montana 3/8/92.
Buckler, Robert P., M.D. 00A124950 Suspended2303 East Ball Road indefinitely effectiveAnaheim, California 4/6/81.
Buckner, John W. 00G387960 Suspended2600 Redondo Avenue indefinitely effectiveLong Beach, California 10/26/94.
Bueno, Rolando Mendoza 00A422080 Suspended513 4th Street East 00A422081 indefinitely effectiveTracy, Minnesota 00A422082 5/17/97.
Bui, Huong Thien, M.D. Suspended1002 Cypress, #10 indefinitely effectiveSanta Ana, California 11/18/88.
Physician ProviderNumber
Bullock, Daniel William, G30957 SuspendedM.D. indefinitely effective701 Pine Street 10/15/03.Mount Shasta, California and 826 Pine StreetMount Shasta, California and 635 Lassen Lane, Suite 110Mount Shasta, California
Bulpit, Donald C. 00A261880 Suspended5118 E. Whittier Boulevard 00A261881 indefinitely effectiveLos Angeles, California 3/23/87.
Burack, Neil D. G54550 SuspendedP.O. Box 696 indefinitely effectiveMcLean, Virginia 9/21/02.
Burke, Marianne C. 00G643390 Suspended1146 North Central Avenue, #177 indefinitely effectiveGlendale, California 06/19/00.
Burke, Robert C 00C221630 Suspended1345 South Westgate indefinitely effective Boulevard, #302 10/28/99.Los Angeles, California
Burkett, Rox C. 00C290530 Suspended10209 Countryside Way indefinitely effectiveSacramento, California 3/3/97.
Burman, Leonard J. C20254 Suspended10 Buckthorn Run indefinitely effectiveVictor, New York 3/7/02.
Burns, David Erin C50049 Suspended902 Frostwood Drive, indefinitely effectiveSuite #307 11/4/2005.Houston, Texas
Bussell, Letantia G30563 Suspended433 North Camden, indefinitely effectiveSuite #805 2/18/2007.Beverly Hills, California and465 N. Roxbury Drive, Suite #912Beverly Hills, California
Buttner, Edgar A. G81147 Suspended11 Exeter, Suite 3 indefinitely effectiveBoston, Massachusetts 1/9/02.
Byland, Samuel S. 00C232730 Suspended1808 San Miguel Drive indefinitely effectiveWalnut Creek, California 8/10/93.
Byram, Barry Ray LA09194R Suspended1961 Maple Avenue, #20 MDD50059 indefinitely effectiveCosta Mesa, California 10/19/00.
Ca-Ching Pan, John, M.D. 00A337200 Suspended2 Fairfax Circle indefinitely effectiveSalinas, California 6/21/91.
1 – Medi-Cal Suspended and Ineligible Provider ListSeptember 2007
susp A9
Physician ProviderNumber
Cacioppo, Dino T. 00A291980 Suspended1532 150th Street 12/18/97San Leandro, California for 15 years.
Cadag, Santiago Tapacio 00A398990 Suspended aka: Santiago T. Cadag 00A398991 indefinitely effective Santiago Cadag 00A398992 1/8/00.12525 Daryl AvenueGranada Hills, California
Caliri, Nicholas J., M.D. 00G478350 Suspended13652 Cantara Street indefinitely effectivePanorama City, California 8/22/88.
Camaya, Araceli E. 00C400410 Suspended430 Pine Street 00C400411 indefinitely effectiveGalt, California 8/20/98.
Campbell, Steven P. 00A418670 Suspended aka: Steven Campbell indefinitely effective4053 18th Street 10/20/99.San Francisco, California
Candelario, Reynalda 00A228650 Suspended2150 Appian Way, Suite 204 indefinitely effectivePinole, California 1/8/92.
Cannon, Mahlon 00C364600 Suspended5727 Ravenspur, #304 indefinitely effectiveRancho Palos Verdes, California 7/10/91.
Carbajal, Ulysses M. A16695 Suspended1189 W. Arrow Highway indefinitely effectiveAzusa, California 7/27/2006.
Carey, Sharon Lee 00G286740 Suspended6413 Enterprise Road indefinitely effectiveGlen Ellen, California 6/6/96.
Carline, Claude T., M.D. 00C120390 Suspended3701 Stocker Street indefinitely effectiveLos Angeles, California 6/1/79.
Carmody, Eugene G. 00G212960 Suspended325 I Street 00G212962 indefinitely effectiveModesto, California 6/23/92.
Carmody, Eugene G. 00G212961 Suspended1801 Tully Road, #D-1 indefinitely effectiveModesto, California 6/23/92.
Carmody, Eugene G. 00G212963 Suspended8 West Swain Road, #3 indefinitely effectiveModesto, California 6/23/92.
Carmody, Eugene G. 00G212964 Suspended1050 N. Carpenter Road, #9 indefinitely effectiveModesto, California 6/23/92.
Carnes, Barton Leroy G6188 SuspendedP.O. Box 1911-Y, Suite 39 indefinitely effectiveTehachapi, California 12/17/01.
Carnine, Kenneth S. SuspendedP.O. Box 2662 indefinitely effectiveRancho Mirage, California 4/9/96.
Physician ProviderNumber
Carranto, Manuel Roque A52020 Suspended5657 Arlington Avenue, #42 indefinitely effectiveRiverside, California 04/01/04.
Carty, Theophile L. G29652 Suspended4842 Hollywood Boulevard indefinitely effectiveLos Angeles, California 6/10/02.
Carty, Theophile L., M.D. 00G296520 Suspended3756 Santa Rosalia Drive 00G296521 indefinitely effectiveLos Angeles, California 00G296522 2/4/82.
Casillas, Ernest Y. A38017 Suspended2155 Verdugo Boulevard, indefinitely effective#211 3/10/03.Montrose, California
Castillo, Cesar O., M.D. 020A33630 Suspended2010 Wilshire Boulevard, indefinitely effective#910 6/21/91.Los Angeles, California
Castillo, Reynaldo 00A399480 Suspended5153 Mt. Melena Avenue 00A399481 4/20/99Los Angeles, California 00A399482 for 10 years.
00A399483
Castillo-Inzunza, Miguel A47746 Suspended Ramons indefinitely effective aka: Castillo, Miguel 4/18/02.1103 Hoover StreetEscondido, California
Castleson, Toksen Rex ME35760 Suspended10061 Rio San Diego Drive, indefinitely effective#297 4/19/01.San Diego, California
Castro, Eduardo A18924 Suspended2929 N. Broadway Street indefinitely effectiveLos Angeles, California 11/30/89.
Castro, Eduardo Enrique G76876 Suspended866 N. Chester Avenue indefinitely effectivePasadena, California 11/30/96.
Catalanello, Mark Jay A49853 Suspended2010 South 8th Street, West, indefinitely effectiveApartment #C 5/21/04.Missoula, Montana
Causey, Dennis Michael 00G506180 SuspendedP.O. Box 14459 indefinitely effectiveSan Francisco, California 8/19/99.
Causey, Dennis Michael 00G506180 Suspended584 Castro Street, #513 indefinitely effectiveSan Francisco, California 02/08/99.
Cavanagh, James G. 00A204020 Suspended3705 South Flagler Drive, #14 indefinitely effectiveWest Palm Beach, Florida 04/06/00.
Cayler, Glen 00A139010 Suspended616 Alhambra Boulevard indefinitely effectiveSacramento, California 11/27/91.
Cech, Stephen A. G10163 Suspended11741 E. Telegraph Road indefinitely effectiveSanta Fe Springs, California 1/21/02.
1 – Medi-Cal Suspended and Ineligible Provider ListSeptember 2007
susp A10
Physician ProviderNumber
Cella, Louis J. Jr., M.D. 000G26590 Temporary309 Civic Center Drive suspension beganSanta Ana, California 5/11/78.
Suspendedindefinitely effective10/1/81.
Chadda, Ropinder Singh A63568 Suspended20329 Del Campo Place indefinitely effectiveWoodland Hills, California 11/4/2004. and8121 Van Nuys Boulevard,Suite #414Panorama City, California
Cenac, Paul E. MD275638 Suspended aka: Paul Edward Cenac indefinitely effective3001 Squalicum Parkway, Suite 16 8/19/99.Bellingham, Washington
Cerevka, Joseph Michal 26777 SuspendedP.O. Box 5138 indefinitely effectiveBeverly Hills, California 12/15/2006.
Cesena, Rebecca 00G413520 Suspended6683 Wandermere Drive indefinitely effectiveSan Diego, California 7/18/96.
Cha, Soon Myung A39746 Suspended1058 South Vermont 149306 indefinitely effective Avenue (New 5/23/02.Los Angeles, California York)
Chaffee, Mahmoud Dean A33185 Suspended1373 Sea Village Drive indefinitely effectiveCardiff, California 9/6/02.
Chahil, Amarjit Singh 00A533300-01 Suspended445 West Eaton Avenue indefinitely effectiveTracy, California 06/14/00.
Chaker, Henry, M.D. 00A019791 SuspendedP.O. Box 9009 indefinitely effective2180 Garnet Avenue, 10/10/90.#1-ASan Diego, California
Chamberlain, Rodney D., 0000G4940 SuspendedM.D. indefinitely effective884 Middlefield Road 11/1/78.Palo Alto, California
Chamberlain, Terry, M.D. 00C284690 Suspended11125 Ridge Road indefinitely effectiveSebastopol, California 1/12/83.
Chan, Michael Cheeluen 31114 Suspended10230 Artesia Boulevard, #218 indefinitely effectiveBellflower, California 5/29/2007. and11660 South Street, #110Los Angeles, California
Chang, Candace 00A620000-03 SuspendedCDC #W77973 indefinitely effectiveValley State Prison 7/16/00.P.O. Box 92Chowchilla, California
Chang, Ming-Kao A48994 Suspended1401 North Aster indefinitely effectiveBroken Arrow, Oklahoma 11/12/03.
Physician ProviderNumber
Chang, Ying Ming 00A424510 Suspended3296 Willard Street indefinitely effectiveSan Diego, California 10/9/95.
Chao, Alfred W. 00A303460 Suspended25 S. Raymond indefinitely effectiveAlhambra, California 9/16/87.
Chaplan, Abraham A. 000G61310 Suspended4435 Nogales Drive indefinitely effectiveTarzana, California 3/7/92.
Chapman, Thomas 00C370600 Suspended Morgan, Jr. 00C370601 indefinitely effective40492 Corte De Opalo 10/20/98.Murrieta, California
Charlet, Jorge, M.D. Physician Suspended6889 Sumter Quay Court Assistant indefinitely effectiveStockton, California 8/16/91.
Charney, Stanton Mel, M.D. 000G76060 Suspended1909 Mowry Avenue indefinitely effectiveFremont, California 8/16/91.
Charney, Stanton Mel, M.D. 000G76060 Suspended6092 Mowry Avenue indefinitely effectiveNewark, California 8/16/91.
Chase, David S. G14199 Suspended183 St. Paul Street indefinitely effectiveMansfield Professional 07/21/03. BuildingBurlington, Vermont
Chattman, Martin S. G24848 Suspended34155 N. Scottsdale Road indefinitely effectiveScottsdale, Arizona 11/26/01.
Chavis, Patrick 00A326280 Suspended14727 Stanford Avenue indefinitely effectiveLos Angeles, California 3/18/99.
Chavis, Patrick A32628 Suspended420 N. Poinsetta Avenue indefinitely effectiveCompton, California 9/24/98.
Checani, Gregg Charles A49952 Suspended9 Clearview Drive indefinitely effectiveNatick, Massachusetts 08/08/00.
Chein, Edmund 00A386780 Suspended aka: Y.M. Chein indefinitely effective2825 Tahquitz Canyon 02/18/00. Boulevard Palm Springs, California
Chen, Samuel P. A38456 Suspended4800 S. Lakeshore Drive, indefinitely effectiveApartment 2501N 8/7/01.Chicago, Illinois
Chen, Shen Eng 00A322030 Suspended3465 Monterey Road 00A322031 indefinitely effectiveSan Marino, California 00A322032 10/26/94.
1 – Medi-Cal Suspended and Ineligible Provider ListOctober 2007
susp A11
Physician ProviderNumber
Chen, Yuan-Fei Chang 00G733240 SuspendedChen & Chen MDs GR0058260 indefinitely effective1850 Azusa Boulevard, 7/14/01.No. 102Hacienda Heights, California
Cheung, Philip W. 00A299290 Suspended1820 Noriego Street indefinitely effectiveSan Francs, California 3/19/90.
Chiang, Philip Chih-Hsiao G84099 Suspended2235 West Middlefield Road indefinitely effectiveMountain View, California 3/20/05.
Cho, Jin Sook AC5797 Suspended1660 West Broadway, indefinitely effectiveApartment 353 2/20/03.Anaheim, California
Choa, Agnes L. A37974 SuspendedP.O. Box 1262 indefinitely effectiveAlhambra, California 11/21/02.
Chong, Byron Ming 00A236150 Suspended535 East Romie Lane indefinitely effectiveSalinas, California 1/3/97.
Chong, Byron A23615 Suspended535 East Romie Lane, indefinitely effectiveSuite #9 9/18/2006.Salinas, California
Chopra, Sawtantar Kumar A29771 Suspended1401 Spanos Court, #128 indefinitely effectiveModesto, California 12/03/02. and 1700 Coffee RoadModesto, California
Chopra, Sawtantra Kumar A29771 Suspended c/o Kirk W. McAllister, Esq. indefinitely effective1012 11th Street, Suite 100 12/3/02.Modesto, California
Choudry, Mayna Meah G82347 SuspendedP.O. Box 788 indefinitely effectiveChowchilla, California 05/03/00.
Christensen, David 00G464900 Suspended81833 Avenue 47, #6 indefinitely effectiveIndio, California 9/15/94.
Christensen, Dennis W. C26098 Suspended1145 Azbourn Court, indefinitely effectiveApartment C 6/20/01.San Francisco, California
Christensen, Warren T. 00A290190 Suspended1090 Lincoln Avenue, 00A290191 indefinitely effectiveSuite 3 020A30180 8/2/96.San Jose, California 020A30181
Physician ProviderNumber
Christopherson, Janice A68142 Suspended Renee indefinitely effective4250 Payne Avenue, 5/28/01.Apartment. 3San Jose, California
Chung, Joseph 00A394270 Suspended503 Euclid Avenue temporarily effectiveNational City, California 2/11/86.
Clark, David Stuart C33959 SuspendedP.O. Box 223799 indefinitely effectiveCarmel, California 7/30/03. or840 W. 5th StreetOxnard, California or2780 W. Shaw AvenueFresno, California or4440 N. 1st Street, #111Fresno, California
Clark, Patrick C. 00C290410 Suspended1600 S. Imperial Avenue, 00C290411 indefinitely effectiveSuite 8 3/27/97.El Centro, California
Clark, Thomas W., M.D. 00A295190 Suspended234 San Vincente indefinitely effective Boulevard, #16 6/21/90.Santa Monica, California
Claytor, Robert K., M.D. 00A279410 Suspended52 E. Main Street indefinitely effectivelone, California 6/29/89.
Clegg, Charles T. 00G135550 Suspended404 S. Mohler Drive indefinitely effectiveAnaheim, California 11/20/97.
Cline, Sherri Lee Suspended13129 Cranston Avenue indefinitely effectiveSylmar, California 4/6/97.
Cloud, Thomas C. G41210 Suspended11911 Magnolia indefinitely effective Boulevard, #8 9/26/01.North Hollywood, California
Cloverdale, Edward 00A289240 Suspended3118 Tulare Street indefinitely effectiveFresno, California 8/28/90.
Cobb, Charles K. SuspendedCommonwealth Health indefinitely effectiveSaipan, MP 2/14/96.
1 – Medi-Cal Suspended and Ineligible Provider ListApril 2007
susp A12
Physician ProviderNumber
Coburn, William M., Jr. 23131 Suspended2220 Lynn Road, #102 indefinitely effectiveThousand Oaks, California 5/30/2007.
Cobbs, Price, M.D. 00C217370 Suspended3528 Sacramento Street 00C217371 indefinitely effectiveSan Francisco, California 2/16/77.
Coffee, Leonard 00G374890 Suspended975 Sereno Drive indefinitely effectiveVallejo, California 1/29/91.
Coffield, Kenneth, M.D., Inc. 000G82670 Suspended801 Toulumne indefinitely effectiveVallejo, California 10/23/82.
Cohen, Melvin W. 00C373940 Suspended517 Wilshire Boulevard indefinitely effectiveSanta Monica, California 5/26/94.
Cohen, Nathaniel M. 000G19040 Suspended5655 E. River Road, 000G19401 indefinitely effectiveSuite 101-207 8/30/96.Tucson, Arizona
Colburn, Michael David 00G656140 Suspended502 Birdie Court indefinitely effectiveOnalaska, Wisconsin 07/05/00.
Cole, Wilson 00A215960 Suspended12532 Chetenham Lane indefinitely effectiveSan Diego, California 03/29/00.
Coleman, James E. Suspended7152 Wheaton Circle indefinitely effectiveWestminster, California 4/13/97.
Collier, Dewitt T., M.D. 00G208600 Suspended 60 5331 Marina Pacific Drive days effectiveLong Beach, California 8/29/91.
Collier, Dewitt T., M.D. 00G208601 Suspended 6012440 E. Firestone days effective Boulevard, #101 8/29/91.Norwalk, California
Collier, Dewitt T., M.D. 00G208602 Suspended 602801 Atlantic Avenue days effectiveLong Beach, California 8/29/91.
Collins, Joan Marianne G75316 Suspended11666 Carmel Creek Road, indefinitely effective#109 03/03/04.San Diego, California
Collins, Matthew Walter G76199 Suspended aka: Collins, Matthew indefinitely effective Charles 08/29/03. Collins, Mathew W.14434 Gilmore StreetVan Nuys, California and 2715 W. Foothill Boulevard, Unit 12San Bernardino, California and1701 E. McFadden Avenue, Suite DSanta Ana, California
Physician ProviderNumber
Colman, Larry Melvin C32794 Suspended310 Tejon Place indefinitely effectivePalos Verdes Estates, 12/30/2004.California and1405 Via CoronelPalos Verdes Estates, California
Colman, Laurence D. 00G575820 Suspended850 Steeles Avenue West, indefinitely effective#1006 4/20/99.Thornhill, Ontario, Canada
Comar, Dave 00A176670 Suspended1323 E. 1st Street 00A176671 indefinitely effectiveLos Angeles, California 00A176672 5/24/96.
00A176673
Cone, Robert Roy 00A289690 SuspendedLista De Correos indefinitely effectiveLa Playas De Tijuana 5/24/01.Tijuana, Baja California NorteMexico
Consolver, Jay Paul C35429 Suspended5530 Corbin Avenue, indefinitely effectiveSuite #313 1/19/2006.Tarzana, California
Cook, David C. G55512 Suspended14075 East Bronte Drive CGP160588 indefinitely effectiveWhittier, California 1/27/99.
Cook, William Robert, Jr. C35683 Suspended1521 Alton Road, #676 indefinitely effectiveMiami Beach, Florida 09/20/04. and480 4th Avenue, Suite 212Chula Vista, California
Cools, Sally, M.D. 00G393090 Suspended40 North Corona Drive indefinitely effectivePorterville, California 8/17/83.
Coonley, Kevin Gerard 00G531940 Suspended1621 Fulton Avenue, indefinitely effectiveSuite 33 04/20/00.Sacramento, California
Cooper, Richard Paul G65857 Suspended234 Hybiscus Avenue, indefinitely effectiveNo. 168 03/03/03.Lauderdale by the Sea, Florida
Cooperman, Steven G. 00G165400 Suspended435 N. Roxbury Drive, #405 indefinitely effectiveBeverly Hills, California 5/13/92.
Cooperman, Steven G. 00G165401 Suspended225 W. 6th Street indefinitely effectiveLos Angeles, California 5/13/92.
Cordova, Marco Antonio SuspendedAV Benito Juarez #28 indefinitely effectiveCal. La Glora 09/20/00.Tijuana, Baja California
1 – Medi-Cal Suspended and Ineligible Provider ListSeptember 2007
susp A13
Physician ProviderNumber
Corners, Jerry Edward G25325 Suspended3400 Irvine Avenue, Suite 108 indefinitely effectiveNewport Beach, California 10/2/01.
Coronado, Victor Jesus 00A402130-4 SuspendedCoronado Medical Clinics GR0064300 indefinitely effectiveAcademy Medical Clinic GR0015040-2 01/03/00.8728 6th StreetDowney, California
Cosgrove, Zachary King 70710 Suspended2400 Wible Road, #14 indefinitely effectiveBakersfield, California 12/15/2006. and601 Plover CourtBakersfield, California
Cotton, Samuel A21395 Suspended231 West Vernon Avenue, indefinitely effectiveSuite #108 2/24/2006.Los Angeles, California
Cox, Christopher M. G58545 Suspended5400 Rosecrans Avenue indefinitely effectiveHawthorne, California 9/28/2006. and4656A Admiralty WayMarina Del Rey, California
Crawford, Byron D. A29605 Suspended7377 Birdview Avenue, #777 indefinitely effectiveMalibu, California 11/15/01.
Cubillas, Victor Suspended222 Calle Lila indefinitely effectiveTijuana, Baja California 09/20/00.
Cuellar, Carlos Unlicensed Suspended for 5P.O. Box 2583 years effectiveHuntington Park, California 4/24/91.
Cuera, Roberto A. 00A194710 Suspended aka: Robert A. Cuera indefinitely effective1221 W. Dwyer Drive 1/17/96.Anaheim, California
Culala, Pascual 00A306630 Suspended1211 Saraglen Drive indefinitely effectiveSaratoga, California 12/7/94.
Cummings, Arthur L., M.D. 00A094540 Suspended1005 Vierra Road indefinitely effectiveRackerby, California 11/11/84.
Cundiff, David Keith 00G351220 Suspended319 Grand Avenue indefinitely effectiveLong Beach, California 09/11/00.
Cyr, James O. 00G418980 Suspended2500 Dayton Durham indefinitely effective Road, Suite 9 6/7/92.Durham, California
Czmus, Akim F. 00G534220 Suspended500 E. Olive Avenue, #840 indefinitely effectiveBurbank, California 8/26/92.
D’Ambrosio, Francis G73590 Suspended Gerard indefinitely effective23852 Pacific Coast 6/1/02. Highway, #793Malibu, California
Physician ProviderNumber
Dalrymple, Anne M. 52730 Suspended207 North Manor Circle indefinitely effectiveTakoma Park, Maryland 6/27/91.
Dalton, Del B. 00A433780-4 Suspended31161 Laguna Niguel Road, indefinitely effectiveSuite L 08/04/00.Laguna Niguel, California
Daniels, Salmon Paul G43879 Suspended4405 South Main Street indefinitely effectiveLos Angeles, California 06/30/04. and1601 North Gower Street, #100Los Angeles, California
Darm, Jerry Roy G44187 Suspended16775 Graef Circle indefinitely effectiveLake Oswego, Oregon 3/13/03.
Davidi, Farhad A41397 Suspended5224 North Figueroa Street indefinitely effectiveLos Angeles, California 4/12/01.
Davis, Clifford Anthony C18031 Suspended3471 Beverly Glen Boulevard indefinitely effectiveSherman Oaks, California 1/24/02.
Davis, Dave Allen G70149 Suspended50 South San Mateo Drive, indefinitely effectiveSuite 440 12/01/03.San Mateo, California
Davis, Irving, M.D. 00A065120 Suspended555 Hyde Street indefinitely effectiveSan Francisco, California 1/1/79.
Davis, John S., M.D. 00G008837 Suspended184 Portola Drive indefinitely effectiveSan Francisco, California 6/24/91.
Davis, Roger Alan C32856 Suspended1601 North Tucson indefinitely effective Boulevard, #14 08/21/00.Tucson, Arizona
Davis, William S. 00C150170 SuspendedBox 118 indefinitely effectiveLos Molinos, California 6/16/86.
Dawson, Bank, M.D. 00G361910 Suspended667 Palm Avenue, #D indefinitely effectiveImperial Beach, California 8/28/90.
Dawson, Walter L. 00A112060 Suspended3030 Bridgeway 00A112061 indefinitely effectiveSausalito, California 12/27/95.
Deacon, Walter E., II 00G396030 SuspendedAmerican Mission Hospital indefinitely effectiveP.O. Box 1 12/2/96.Arabian Gulf, Bahrain
De Bardlabon, Herman A41217 Suspended14405 Cerise, #40 indefinitely effectiveHawthorne, California 12/27/01.
1 – Medi-Cal Suspended and Ineligible Provider ListOctober 2007
susp A14
Physician ProviderNumber
DeFriez, Curtis B. 00G597250 Suspended2995 East 3135 South 00G597251 indefinitely effectiveSalt Lake City, Utah 10/7/96.
De Gaston, Alexis Neal A3462 Suspended900 S. Main Street, indefinitely effectiveSuite 206 12/18/02.Corona, California and10487 Peppergrass WayMoreno Valley, California and12712 Heacock Street, Suite 7Moreno Valley, California
DeGregorio, Peter A. 19551 Suspended13652 Cantara Street indefinitely effectivePanorama City, California 12/15/2006.
DeHaven, Harry E., M.D. 00C176370 Suspended8440 Sunset Boulevard 00C176371 indefinitely effectiveLos Angeles, California 00C176372 11/19/79.
Deitzler, Margaret 000G73970 Suspended2818 Bayview Drive indefinitely effectiveAlameda, California 5/27/94.
Delgado, Carlos 00A203830 SuspendedP.O. Box 1199 indefinitely effectiveCebu City, Philippines 6/18/98.
DeLilly, Mayo R. 00C131690 Suspended18285 Western Avenue indefinitely effectiveLos Angeles, California 11/20/89.
Del Real, Frank G58375 Suspended2248 North Warren Avenue indefinitely effectiveFresno, California 9/10/02.
Demery, Leroy W., M.D. 00A286780 Suspended6213 South Main Street indefinitely effectiveLos Angeles, California 11/28/81.
Demetrios, Abbas Halim 00C414950 SuspendedP.O. Box 192 00C414951 indefinitely effectiveLake Isabella, California 5/3/96.
DeNardo, Mary Alice A24301 Suspended226 West Edith, #23 indefinitely effectiveLos Altos, California 3/19/98.
Dennis, Gwenda B. 00G595120-1 Suspendedc/o 24953 Paseo de Valencia indefinitely effectiveLaguna Hills, California 05/18/00.
DeRosis, Edward Louis GFE49067 Suspended1044 Sir Francis Drake indefinitely effective Boulevard 8/20/02.Kentfield, California
Devine, James S. 000G39380 Suspended6029 Linda Way indefinitely effectiveCulver City, California 6/17/99.
Physician ProviderNumber
Devous, A. Scott, M.D. 00C408510 Suspended1724 Sacramento, #14 indefinitely effectiveSan Francisco, California 3/12/85.
Dia, Mohammad F. 00A218770-79 Suspended23560 Madison #204 indefinitely effectiveTorrance, California 4/20/00.
Dibaji, Said, M.D. 00A308240 Suspended829 F Street indefinitely effectiveFresno, California 8/2/83.
Dichter, Terry A. A23930 Suspended2736 Florence Avenue indefinitely effectiveHuntington Park, California 1/29/01.
Dickens, Charles N. Suspended54805 Inverness Way indefinitely effectiveLa Quinta, California 1/5/97.
Dimapilis, Apolonia 00A218790 Suspended2087 21st Avenue indefinitely effectiveSan Francisco, California 5/15/95.
Dinglasan, Gualberto R. A38324 Suspended626 County Oak Road indefinitely effectiveSan Dimas, California 5/22/02.
Dinh, Hung T., M.D. 00A330240 Suspended10934 Elena Street 00A330241 indefinitely effectiveCerritos, California 4/5/85.
D’morias, Jeremy L. A48535 Suspended505 East Chesapeake Drive 2/20/00Fresno, California for 10 years.
Do, Hung V., M.D. 00A384600 Suspended11801 Ingelwood Avenue 00A384601 indefinitely effectiveHawthorne, California 8/31/85.
Do, Kevin T. G76640 Suspended309 South Robertson Boulevard indefinitely effectiveBeverly Hills, California 3/7/03.
Do, Son, M.D. 00A387640 Suspended165 East Holt Avenue indefinitely effectivePomona, California 4/18/85.
Dobrow, Bernard 00C115990 Suspended125 El Porton indefinitely effectiveLos Gatos, California 4/21/95.
Dodd, Warren Duane 00G518720 Suspended1447 Calle Yucca indefinitely effectiveThousand Oaks, California 8/18/00.
Dodge, Jack I. G55196 Suspended413 Fair Oaks Avenue indefinitely effectiveMitchell, South Dakota 10/13/2004.
1 – Medi-Cal Suspended and Ineligible Provider ListSeptember 2007
susp A15
Physician ProviderNumber
Dolores, Michael Suspended35 Sussex Street indefinitely effectiveSan Francisco, California 9/11/95.
Donaldson, Karen Ann G30545 Suspended555 Tachevah Drive, indefinitely effectiveBuilding 1E203 4/11/01.Palm Springs, California
Donat, Peter C. A26192 Suspended25152 Sandia Court indefinitely effectiveLaguna Hills, California 06/09/03.
Donovan, James Francis G10371 Suspended1906 Oceanside indefinitely effective Boulevard, Suite #G-120 11/22/2004.Oceanside, California and3535 San Dimas Street,Suite #12Bakersfield, California
Donshik, Jon David G85113 Suspended301 NW 84th Avenue, indefinitely effectiveSuite #303 9/28/04.Plantation, Florida
Doran, Andrew J. Connick G2718 Suspended4445 Dundee Drive indefinitely effectiveLos Angeles, California 2/12/03.
Dosumu-Johnson, Thomas 00A034329 Suspended5222 Balboa Avenue, #62 indefinitely effectiveSan Diego, California 6/24/91.
Drake, Carl E., M.D. 00C290740 Suspended135 San Benito Way indefinitely effectiveSan Francisco, California 7/13/83.
Drake, Samuel L. 00C376640 Suspended1757 Henderson Court indefinitely effectiveVista, California 2/22/95.
Drucker, Robert Neil 00A318890 Suspended1333 Jefferson Street indefinitely effectiveNapa, California 3/27/97.
Drye, Robert C., M.D. 000G36180 Suspended426 Palm Avenue, #1 indefinitely effectiveSeaside, California 10/25/91.
Dugas, Jean M. 00A275400 Suspended4730 47th Avenue 00A275401 indefinitely effectiveSacramento, California 00A275402 7/20/99.
Dulkanchainun, Sathit B. A62004 Suspended10888 Vinedale Street indefinitely effectiveSun Valley, California 7/9/01.
Duncan, Monique Suspended13212 Towne Avenue indefinitely effectiveLos Angeles, California 4/6/97.
Dunn, William J. 00C226210 Suspended4655 Hoen Avenue indefinitely effectiveSanta Rosa, California 6/30/01.
Duong, Bai Thi, M.D. Suspended9433-B Bolsa Avenue indefinitely effectiveWestminster, California 11/18/88.
Physician ProviderNumber
Dupraw, Ernest Joseph Jr. G27741 SuspendedP.O. Box 7376 indefinitely effectiveStockton, California 11/20/03. or27350 Valley Center RoadValley Center, California
Duran, Paul Joseph A60506 Suspended11645 Wilshire Boulevard, indefinitely effectiveSuite #1070 7/29/2005.Los Angeles, California and1328 22nd StreetSanta Monica, California
Dwyer, Dan Edward G76798 Suspended1485 Millar Drive indefinitely effectiveGlendale, California 04/12/00.
Dye, Richard Berry A56198 Suspended585 Kelly indefinitely effectiveHalf Moon Bay, California 05/05/03.
Easler, Kenneth 00C236850 Suspended11569 Walton Heath Road 00C236851 indefinitely effectiveSan Diego, California 7/2/97.
Eckstein, Larry G29690 Suspended2760 29th Street, indefinitely effectiveSuite #2D 6/16/2006.Boulder, Colorado and1437 7th Street,Suite #301Santa Monica, California
Eddy, Donald D. Suspended2642 Yorkshire Road indefinitely effectiveRiverside, California 10/20/98.
Edwards, Arthur G. C20011 Suspended6001 Bellevue Avenue indefinitely effectiveLa Jolla, California 2/07/03.
Edwards, Robert Norfleet C39176 Suspended4509 South 6th Street, indefinitely effectiveSuite #311 4/11/2005.Klamath Falls, Oregon and1745 Washburn WayKlamath Falls, Oregon
Eglin, Jack AFE27781 Suspended356 E. Olive Street indefinitely effectiveBurbank, California 7/5/02.
Eley, Elmer L. A39100 Suspended22938 Deberry Street indefinitely effectiveGrand Terrace, California 3/7/01.
Elian, Gilbert J. 00G265580 Suspended4585 Stevens Creek, #100 indefinitely effectiveSanta Clara, California 4/21/95.
Elkjer, James Dwight C33589 Suspended1201 West 186th Street indefinitely effectiveGardena, California 1/3/02.
1 – Medi-Cal Suspended and Ineligible Provider ListNovember 2006
susp A16
Physician ProviderNumber
El-Toukhy, Mohamed A41652 Suspended Samy indefinitely effective3130 Beaudry Terrace 6/5/01.Glendale, California
Elul, Rafael 00A263640-1 SuspendedP.O. Box 882941 indefinitely effectiveSan Francisco, California 03/24/00.
Ely, Stephen Robert DC0177790 Suspended2900 Fresno Street indefinitely effectiveFresno, California 1/20/98.
Emery, Clyde K. G12561 Suspended aka: Emery, Clyde indefinitely effective K.M., Jr. 04/01/03. Emery, Clyde K., Jr.23451 Madison Street, Suite 250Torrance, California and 1000 Ryland StreetReno, Nevada
Emmi, Michael Joseph DC-17470 Suspended8220 Katella Avenue, indefinitely effectiveSuite B 11/07/03.Stanton, California
Eng-Perez, Fernando Suspended aka: Fernando Eng indefinitely effectiveBarejonal Este 23621 09/20/00.Col. Lomas de la PresaTijuana, Baja California
Engeberg, William D. A13109 Suspended5219 South Garth Avenue indefinitely effectiveLos Angeles, California 08/01/03.
Engelmann, Guy R. Suspended1171 Bush, #2 indefinitely effectiveSan Francisco, California 4/2/97.
Ergin, Nevit O. C37305 Suspended1022 N. Branciforte Avenue indefinitely effectiveSanta Cruz, California 11/16/00.
Escajeda, Richard M. G4088 Suspended2266 Albatross Street, #B indefinitely effectiveSan Diego, California 1/11/2005.
Espinoza, Rurico Robert 00A240470 Suspended2521 West Pico Boulevard 00A240471 indefinitely effectiveLos Angeles, California 3/18/99.
Evans, Ronald D., M.D. 00C336500 Suspended7309 Apache Trail indefinitely effectiveYucca Valley, California 12/13/90.
Everett, Judith E. 00G132480 Suspended9855 Erma Road, #121 indefinitely effectiveSan Diego, California 5/18/87.
Ezra, Joseph 00A313540 SuspendedP.O. Box 500 CGP045675 8/26/97Boron, California for 10 years.
Physician ProviderNumber
Fagenstrom, Patrick 00G360290 Suspended Cregor indefinitely effective1947 Cable Street 12/30/99.San Diego, California
Fahlsing, Edwin L. 000G96950 Suspended770 Washington Street indefinitely effectiveSan Diego, California 8/16/91.
Fam, Farid Hanna A33454 Suspended3440 West Shaw indefinitely effectiveFresno, California 04/12/02.
Fandino, Senador V. 00A326040 Suspended2939 Alta View Drive, indefinitely effectiveSuite J 12/9/96.San Diego, California
Farhadi, Touradj A51505 Suspended dba: Panacea Health Care indefinitely effective Medical Group 9/19/02.11711 Ohio Avenue, # 201Los Angeles, California
Farmer, Richard 00C256880 SuspendedUniversity of Tennessee 00C256881 indefinitely effectivePsychology Department 1/16/97.66 N. Pauline, Suite 633Memphis, Tennessee
Farmer, Robert A. 00C387320 Suspended600 Nut Tree Road, #330 indefinitely effectiveVacaville, California 6/12/95.
Farrell, George R. C14810 SuspendedP.O. Box 90591 indefinitely effectiveSan Diego, California 5/8/02.
Fazil, Mohammad A35835 Suspended14350 East Whittier Boulevard indefinitely effectiveWhittier, California 3/7/03.
Feagin, Clarence Andrew G56398 Suspended120 Broadway Avenue, indefinitely effectiveSuite 21 05/15/02.Richmond, California
Fein, Gerald 00G150200 Suspended aka: Gerald I. Fein CGP084905 indefinitely effective Jerry Fein 2/18/99. dba: Gerald I. Fein, M.D., Inc.P.O. Box 5185Palos Verdes, California
Feldman, Benjamin J. 000C95030 Suspended1 St. Mary’s Court 000C95031 indefinitely effectiveRancho Mirage, California CGP039110 9/23/96.
Feldman, Ross 000G78780 Suspended11896 Beach Club Way CGP018970 indefinitely effectiveMalibu, California 2/18/99.
Felkel, John R. G25038 Suspended18300 U.S. Highway 18 indefinitely effectiveApple Valley, California 8/8/2005.
Ferdows, Dean (Majdein) 00A463600 Suspended22030 Sherman Way, indefinitely effectiveSuite 110 11/21/00.Canoga Park, California
1 – Medi-Cal Suspended and Ineligible Provider ListNovember 2006
susp A17
Physician ProviderNumber
Ferguson, John S. 00C246510 Suspended630 Devon Place indefinitely effectiveLong Beach, California 5/9/88.
Fermin, Ramon Espinas C50663 Suspended272 Puffin Court indefinitely effectiveFoster City, California 08/06/03.
Fernabach, Louise Oftedal G1649 Suspended11 Orchard Road indefinitely effectiveCharlottesville, Virginia 05/01/02.
Fernando, Rolando A38385 Suspended Asuncion indefinitely effective6221 Wilshire Boulevard, 09/01/03.Suite 404Los Angeles, California
Fiddes, Robert Alan 00A243770-71 Suspended12291 East Washington indefinitely effective Boulevard, Suite 106 03/15/00.Whittier, California
Field, Steven A. 23165 Suspended905 Guisando De Avila indefinitely effectiveTampa, Florida 3/20/06.
Figueroa, Pascual SuspendedSilverio Aleman 2217 indefinitely effectiveCol. Lopez Leyva 09/20/00.Tijuana, Baja California
Fineberg, Steven Lee A62677 Suspended1128 16th Street indefinitely effectiveSanta Monica, California 7/14/01.
Fisch, Alan G14420 Suspended149 Buckminster Road indefinitely effectiveBrookline, Massachusetts 10/25/01.
Fischer, Peter B. 00G186920 Suspended9400 E. Rosecrans indefinitely effectiveBellflower, California 2/18/99.
Fisher, Stephen Neal G54042 Suspended5600 Munhall Road, indefinitely effectiveApartment #803 4/10/2001.Pittsburgh, Pennsylvania
Flanigan, George Dalton, III A47749 Suspended11633 Hawthorne Boulevard, indefinitely effectiveSuite #103 10/20/05.Hawthorne, California
Fleming, Richard E. C18390 Suspended148 Casa Street indefinitely effectiveSan Luis Obispo, California 5/9/02.
Physician ProviderNumber
Flores, Byron Solorzano A52173 SuspendedSalvador Del Mundo indefinitely effective Medical Clinic 2/12/2007.8301 South Vermont AvenueLos Angeles, California and6125 Whittier BoulevardLos Angeles, California and4070 East Olympic BoulevardLos Angeles, California and1508 North California StreetBurbank, California
Flores, Jorge N. A33705 Suspended4036 Whittier Boulevard, indefinitely effectiveSuite #201 10/17/05.Los Angeles, California and10001 California AvenueSouth Gate, California and11227 Valley BoulevardEl Monte, California
Flores, Jose Luis A69861 Suspended1207 Fairchild Court indefinitely effectiveWoodland, California 3/1/2006.
Flowers, John A., M.D. 00C371210 Suspended23310 Marigold Street indefinitely effectiveTorrance, California 12/9/86.
Fong, Reynaldo, M.D. 00A324380 Suspended555 West Benjamin Holt, 00A324381 indefinitely effective#323 00A324382 2/26/83.Stockton, California
Ford, William Harold 00C256600 Suspended7018 Blair Road indefinitely effectiveCalipatria, California 10/8/97.
Forester, Bruce M. G14147 Suspended55 Northway indefinitely effectiveBronxville, New York 01/16/04.
Forgey, Burnell Gordon 00A106020 Suspended333 E. 17th Avenue, indefinitely effectiveSuite 17 8/20/98.Costa Mesa, California
Foster, Kenneth, M.D. 00G424750 Suspended 60528 Rio Street days effectiveRed Bluff, California 9/11/91.
Foster, Kenneth W. 00G424750 SuspendedP.O. Box 182 indefinitely effectiveHoldenville, Oklahoma 11/26/93.
Fouqette, John Kenneth G40263 Suspended92850 River Road indefinitely effectiveJunction City, Oregon 09/19/03. and3215 Fortune CourtAuburn, California and193rd and Church StreetGeorgetown, California
1 – Medi-Cal Suspended and Ineligible Provider ListMarch 2007
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Physician ProviderNumber
Fouts, Gregory G. GFE8590 Suspended25 Deertrail Road indefinitely effectiveLaFayette, California 08/27/03. and 2222 East Street, Suite 250Concord, California
Fox, Robert Scott G78351 SuspendedP.O. Box 2254 indefinitely effectiveSeward, California 05/20/03.
Fraide, Raul 00A113690 Suspended951 South Beach Boulevard 00A113691 indefinitely effectiveLa Habra, California 9/6/94.
Frank, Kenneth A., M.D. 00G380380 Suspended3001 Atalcina Drive indefinitely effectiveBakersfield, California 4/5/91.
Franklin, Aram AFE10270 Suspended65 Lakefront indefinitely effectiveIrvine, California 10/10/02.
Frederick, Harold T. 00A166120 Suspended8515 East Florence Avenue indefinitely effectiveDowney, California 2/20/98.
Free, Kevin Russell G65529 Suspended14 Patten Terrace indefinitely effectiveCedar Grove, New Jersey 5/20/98.
Freedlander, Dean Gary 00G354870 Suspended17705 Hale Avenue, H3 indefinitely effectiveMorgan Hill, California 06/19/03.
Freeman, Dean A. 00A479230 SuspendedCDC # P51824 indefinitely effectiveSan Quentin State Prison 09/15/99.P.O. Box P51824San Quentin, California
Freeman, Terry Mitchell 00A388630 Suspended2262 S. Beverly Drive indefinitely effectiveLos Angeles, California 11/20/97.
Freer, Everett Charles G32220 SuspendedP.O. Box 1967 indefinitely effectivePahrump, Nevada 09/19/03. and1401 E. Lake Mead BoulevardN. Las Vegas, Nevada
Friedman, Bruce, M.D. 00A123080 Suspended1310 Jones Street, #503 indefinitely effectiveSan Francisco, California 9/20/95.
Frocht, Alexander A38713 Suspended36 Olola Avenue indefinitely effectiveValucuse NSW 2030 04/04/03.Australia
Physician ProviderNumber
Fukuji, Shigeto 00A285860 Suspended4732 E. Third Street ZZZ31910Z indefinitely effectiveLos Angeles, California 4/10/87.
Fuller, Henry L. A11855 SuspendedP.O. Box 1010 indefinitely effectivePine Grove, California 7/5/2005. and19681 Highway 88Pine Grove, California and216 East MarletteIone, California
Fulton, James Edwin, Jr. C32711 Suspended1236 Somerset Lane indefinitely effectiveNewport Beach, California 8/13/03. and430 South Western Avenue,Suite #206Los Angeles, California and18440 Burbank BoulevardTarzana, California
Furmanski, Stanley H. A25499 Suspended1015 Gayley Avenue, #256 indefinitely effectiveLos Angeles, California 3/27/02.
Futch, Ronald, M.D. 00A307720 Suspended2210 Wilshire Boulevard, indefinitely effective#232 4/19/84.Santa Monica, California
Gadsby, Michael Owen 00G772230 Suspended817 Orange Grove Place indefinitely effectiveSouth Pasadena, California 11/19/98.
Galloway, William F., M.D. 00C331260 Suspended1589 Soto Street indefinitely effectiveSeaside, California 7/16/91.
Galluzzi, Vincent Nicholas 00G192170 Suspended c/o Soledad Central indefinitely effective Correction 12/20/98.P.O. Box 689Soledad, California
Gamage, Kevin 00A456410 Suspended aka: Nimal Gamage 00A456411 indefinitely effective21175 Boccaccio Court 6/29/95.Moreno Valley, California
Gamm, Stanford R. A10698 Suspended20 Hoods Point Way indefinitely effectiveSan Mateo, California 06/09/03.
Gandotra, Suresh, M.D. 00A296770 Suspended215 S. Owens Drive indefinitely effectiveAnaheim, California 1/31/91.
Ganti, Shashi Dhar 00A388300 Suspended10 Congress Street, 00A388301 indefinitely effective Suite 505 6/12/95.Pasadena, California
1 – Medi-Cal Suspended and Ineligible Provider ListMarch 2007
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Physician ProviderNumber
Ganssle, John D. A41508 Suspended601 Van Ness Avenue, indefinitely effectiveNo. 3-132 10/31/01.San Francisco, California or400 E. Main Street, Suite 200Stockton, California orP.O. Box 7979Stockton, California or16360 Roscoe Boulevard, Suite 200Van Nuys, California
Garabet, Antoine Leon G50394 Suspended aka: Garabet, Tony indefinitely effective840 North Pennsylvania 3/28/03. AvenueGlendora, California
Garcia, Bienvenido, M.D. 00A232190 Suspended540 N. California Street indefinitely effectiveStockton, California 8/26/81.
Garcia, Randal L., M.D. 00G044501 Suspended446 Oak Street indefinitely effectiveP.O. Box 1119 6/24/91.Brooking, Oregon
Gard, Zane R. 00A288590 Suspended3888-B Calle Fortunada indefinitely effectiveSan Diego, California 7/27/91.
Gardner, David G. G21702 Suspended15920 Valley Vista indefinitely effectiveBoulevard 4/13/02.Encino, California
Gardner, James D. G51158 Suspended851 E. Sparrow Court indefinitely effectiveFresno, California 10/15/01.
Garibian, Ara A55840 Suspended aka: Garry, Alex indefinitely effectiveP.O. Box 7430 11/03/03.Burbank, California
Garland, Leslie C. 000G85510 Suspended3500 Lomita Boulevard, indefinitely effectiveSuite 201 10/8/97.Torrance, California
Gee, Steven H. C20869 Suspended595 Estudillo Avenue indefinitely effectiveSan Leandro, California 5/16/2002.
Gehring, Del E. C32239 Suspended1616 Marlo indefinitely effectiveDavenport, Iowa 5/4/04.
Geller, Paul J. A19435 Suspended8920 Wilshire Boulevard, indefinitely effectiveSuite #310 7/5/2005.Beverly Hills, California
Physician ProviderNumber
Geller, Stanley J. 00A119960 Suspended1460 Bridgeview Drive 00A119961 indefinitely effectiveSan Diego, California 4/15/97.
Gemici, Murat O. A69511 Suspended1420 Centre Avenue, indefinitely effective#1100 4/15/04.Pittsburgh, Pennsylvania
George, Garry Leonard 00C393490-91 Suspended4929 Alejo Street indefinitely effectiveSan Diego, California 05/30/00.
Gergans, Gregory Alan G47499 Suspended2221 Grant indefinitely effectiveEvanston, Illinois 3/28/01.
Germann, Timothy D. 00A169630 Suspended15001 Mission Hills indefinitely effectiveMission Hills, California 9/20/99.
Giarrusso, Karen Aileen A76596 Suspended3481 Lakeside Drive, indefinitely effectiveNorth East, Unit 607 3/30/04.Atlanta, Georgia
Giddings, John A. A22107 Suspended931 Buena Vista, #101 indefinitely effectiveDuarte, California 3/20/03.
Gigas, Gunter George A38771 Suspended1550 Earl Street indefinitely effectiveKingsburg, California 1/19/2006.
Gil, Alejandro Esteban 37558 SuspendedP.O. Box 29157 indefinitely effectiveLos Angeles, California 9/12/2007.
Gill, Muzaffar Lateef A63446 SuspendedShifa International indefinitely effective Hospital, Sector H-8/4 8/10/2005.Islamabad, Pakistan
Gillespie, Larrian Marie G31664 Suspended264 South La Cienega indefinitely effective Boulevard, #1233 1/6/97.Beverly Hills, California
Gilman, Bradley Wade A65172 Suspended4 Cartier Aisle indefinitely effectiveIrvine, California 6/1/2004.
Gipson, Buford, Jr. Suspended27661 Eastvale Road indefinitely effectivePalos Verdes, California 4/17/96.
Godby, Paul J. 00G131540 Suspended9313 Valley View indefinitely effectiveAlta Loma, California 1/20/98.
Godwin, James S. 00C252240 Suspended8848 N. Hildreth Lane indefinitely effectiveStockton, California 7/20/95.
Goei, Gordon 00A230540 Suspended aka: Gordon S. Goei 00A230541 indefinitely effective9033 Wilshire Boulevard, 00A230542 3/18/99.Suite 306 00A230543Beverly Hills, California 00A230544
1 – Medi-Cal Suspended and Ineligible Provider ListOctober 2007
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Physician ProviderNumber
Goetz, Bernard A36006 Suspended736 North Vista Street indefinitely effectiveLos Angeles, California 3/24/06. and6317 Wilshire Boulevard,Suite 307Los Angeles, California and2928 Cesar ChavezLos Angeles, California
Gold, Lawrence Harvey 61305 Suspended Allan indefinitely effective176 North Little John 7/11/2006. CourtWestlake Village, California
Goldberg, Henry M. G10512 Suspended4800 North Federal indefinitely effective Highway, #205-B 8/2/02.Boca Raton, Florida
Goldberg, Irwin C. 00G593740 Suspended853 Larabee Street indefinitely effectiveWest Hollywood, California 6/18/98.
Goldberg, Lawrence D. 00G443270 Suspended38655 9th Street East, #D indefinitely effectivePalmdale, California 2/26/91.
Goldfarb, Arthur N. 00A191210-2 Suspended42150 67th Street indefinitely effectiveWest Lancaster, California 05/25/00.
Goldfine, Brian David A50067 Suspended44-100 Monterey Avenue, indefinitely effectiveSuite 207 9/26/02.Palm Desert, California
Goldstein, Herbert S. 000G33710 Suspended1820 Ogden Drive indefinitely effectiveBurlingame, California 7/29/87.
Goldstein, Jay Alan G16801 Suspended10632 South Meads indefinitely effectiveOrange, California 11/24/03. or810 W. Compton Boulevard Compton, California or6060 N. Paramount BoulevardLong Beach, California or701 N. Glassell StreetOrange, California
Goldwag, William J., M.D. 00G240380 Suspended7433 Cerritos indefinitely effectiveStanton, California 2/25/86.
Gomez, Fabian 00C358860 Suspended711 W. Whittier Boulevard 00C358861 indefinitely effectiveMontebello, California 6/06/94.
Gomez, Nicholas P. 37700 Suspended1750 Bramblewood Court indefinitely effectiveChula Vista, California 7/15/2007.
Gong, Saul M. G7964 Suspended157 Fairlawn Drive indefinitely effectiveBerkeley, California 8/20/01.
Physician ProviderNumber
Gonzalez, Guillermo F. A14159 Suspended6729 Hermosa Avenue, indefinitely effectiveSuite 121 11/28/01.Rancho Cucamonga, California
Gordon, Leon 000G31750 Suspended2060 Forest Avenue indefinitely effectiveSan Jose, California 12/7/77.
Goss, Seymour A., M.D. 00A022441 Suspended12440 Firestone Boulevard, indefinitely effective#101 6/24/91.P.O. Box 22222Los Angeles, California
Grandotra, Suresh 00A296770 Suspended215 S. Owen Drive indefinitely effectiveAnaheim, California 1/3/90.
Gravador, Lourdes 00A297950 Suspended5134 N. Meadow Wood indefinitely effective Avenue 9/20/99.Lakewood, California
Gravelle, Rodrique, M.D. 000G18000 Suspended6743 Long Beach indefinitely effective Boulevard 3/10/83.Long Beach, California
Graves Jr., James F. G68069 Suspended224 E. Garden Street, indefinitely effectiveApartment 415 7/9/01.Pensacola, Florida
Graves, Joseph P. 00A436000 Suspended aka: Joseph P. Limoli indefinitely effective8929 University Center 1/27/99. Lane, Suite 101San Diego, California
Graves, Thomas Rucker C35817 Suspended2212 57th Street East indefinitely effectiveBradenton, Florida 12/26/01.
Gravich, Anna A40805 Suspended2515 Apollo Drive indefinitely effectiveLos Angeles, California 6/8/01.
Gray, William G. 00C304990 Suspended aka: William Gilman Gray indefinitely effective5208 Archer Drive 6/24/96.Roanoke, Virginia
Green, Kenneth S. A49320 SuspendedP.O. Box 90394 indefinitely effectiveSan Diego, California 6/27/01.
Green, Philip 00A200110 Suspended4311 Coronet Drive indefinitely effectiveEncino, California 2/19/87.
Green, Richard Gordon G23694 SuspendedP.O. Box 1860 indefinitely effectiveHuntington, New York 09/06/00.
Green, Samuel Marvin A00044615 Suspended c/o FCI Morgantown indefinitely effectiveGreenbag Road 04/26/00.P.O. Box 1000Morgantown, West Virginia
1 – Medi-Cal Suspended and Ineligible Provider ListAugust 2007
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Physician ProviderNumber
Greenberg, Gerald Kevin 00G491450 Suspended25500 Rachno Miguel indefinitely effective Road, Suite 240 03/01/00.Laguna Beach, California
Greenberg, Sanford G35672 Suspended Joseph indefinitely effective11 Taylor Avenue 06/04/04.Palm Desert, California
Greenson, Daniel Peter A21872 Suspended2340 Ward Street, indefinitely effectiveSuite 101 02/14/03.Berkeley, California
Gregory, Buford 00AX31560 Suspended7050 Parkway 00AX31561 indefinitely effectiveLa Mesa, California 10/18/88.
Grier, Barnett 00A236170 Suspended2418 Gage Avenue indefinitely effectiveHuntington Beach, California 6/6/94.
Grier, Raymond Edward A32041 SuspendedP.O. Box 126 indefinitely effectiveMoreno Valley, California 5/29/02.
Grier, William 00C277810 Suspended231 W. Vernon Avenue, indefinitely effective#204 4/22/92.Los Angeles, California
Griffiths, Harold M. 00G100370 Suspended755 S. Fairmont indefinitely effectiveLodi, California 3/6/92.
Griswold, Alexander, M.D. C9521 SuspendedP.O. Box 0876 indefinitely effectiveBrea, California 07/23/03. and 327 North Western AvenueLos Angeles, California
Grobler, Nicolas M. 00A392060 Suspended1010 Terrace Drive indefinitely effectiveUpland, California 1/10/92.
Grobovsky, Laura Vanini 83628 Suspended1929 Lone Oak Road indefinitely effectiveJohnson City, Tennessee 9/25/2006.
Gromis, Michael, M.D. 00G297290 Suspended 60110 N. Valeria, #501 days effectiveFresno, California 3/30/91.
Physician ProviderNumber
Gross, Benjamin G41777 Suspended B. Gross MD Medical indefinitely effective Foundation 6/22/01.425 South Fairfax Avenue, #302Los Angeles, California
Gross, Joel Alan 44417 SuspendedP.O. Box 1472 indefinitely effectiveLafayette, California 2/21/2007.
Grossi, Loretta 00A289740 Suspended1111 East Ocean, Suite 4 indefinitely effectiveLompoc, California 10/21/94.
Guinto, Natividad 00A416550-51 Suspended aka: Natividad Guinto indefinitely effective Aguilera 11/21/00.235 West Carson StreetCarson, California
Guidry, Paul L., Jr., M.D. 73021 Suspended3701 Stocker Street, #309 indefinitely effectiveLos Angeles, California 2/14/2007.
Gunn, Herbert H., M.D. 00C035382 Suspended1818 S. Western Avenue, indefinitely effective#103 9/28/90.Los Angeles, California
Gutstein, Robert 00G154340 Suspended28222 Agoura Road 00G154341 indefinitely effectiveAgoura Hills, California 7/1/94.
Habenicht, James C. 00G147230 Suspended14073 Orange indefinitely effective Blossom Road 12/14/94.Oakdale, California
Hager, Jerome P. 00C394890 Suspended7101 Magnolia Avenue, indefinitely effectiveSuite A 2/17/93.Riverside, California
Hales, Ernest L., M.D. 00A247130 Suspended3320 Los Cayotes indefinitely effectiveLong Beach, California 11/17/88.
Halil, Saihb Sinube 00A393480 SuspendedCentral Medical Department indefinitely effectiveOB-GYN Department 7/10/95.Mayaguez, Puerto Rico
Halloran, William X. 00C231860 Suspended8 Tanglewood indefinitely effectiveIrvine, California 12/19/92.
Halstead, Bruce W. 00A125970 Suspended22807 Barton Road indefinitely effectiveGrand Terrace, California 1/19/92.
1 – Medi-Cal Suspended and Ineligible Provider ListSeptember 2007
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Physician ProviderNumber
Hamilton, Cynthia Jean A465590 Suspended245 Watson Lane indefinitely effectiveAmerican Canyon, California 10/10/00.
Hamilton, William A30470 Suspended Gordon indefinitely effective420 Ash Street, 7/20/2006.Apartment #6San Diego, California
Hammesfahr, William G62117 Suspended Michael indefinitely effective600 Druid Road East 2/25/03.Clearwater, Florida
Hampton, William Wilson 41730 Suspended3505 Long Beach indefinitely effective Boulevard, #1D 5/29/2007.Long Beach, California
Han, In Kyo 00A360800 Suspended3655 N. Dillard Avenue 00A360801 2/18/99Claremont, California for 10 years.
Hansen, Lori Eldean G51951 Suspended4901 Richmond Square, indefinitely effectiveSuite 102 01/18/02.Oklahoma City, Oklahoma
Hansen, Stephen C. 00G318230 Suspended4835 Carriage Lane indefinitely effectiveSanta Rosa, California 4/24/95.
Hansen, Terrence C. 00C288940 Suspended900 Kiely Boulevard indefinitely effectiveSanta Clara, California 2/28/97.
Harrington, Donald A25501 Suspended Fremont indefinitely effective22/19 To Khu Pho 8/29/02.Phuong Linh ChieuThu Duc, Vietnam
Harris, Alan D. G13779 Suspended7060 Clairmont Mesa indefinitely effective Boulevard 3/6/01.San Diego, California
Harris, Christopher E. G85347 Suspended19556 Taylor Court indefinitely effectiveMundelein, Illinois 7/30/01.
Harris, Clifton Gordon, III 00G246450 Suspended527 North Shirk Road indefinitely effectiveVisalia, California 01/19/00.
Harris, Henry D. G39781 Suspended916 West 84th Street, indefinitely effectiveApartment 3 10/3/01.Los Angeles, California
Harris, Leonard C. 00G455640 Suspended5725 Lemon Avenue indefinitely effectiveLong Beach, California 6/12/92.
Physician ProviderNumber
Harris, Verne Duncan 00G421140 Suspended622 W. Duarte Road, indefinitely effectiveSuite 202 9/20/99.Arcadia, California
Hartelius, Ebbe, M.D. 00A291340 Suspended2345 East Coast Highway 0020C1240 indefinitely effectiveCorona Del Mar, California 8/8/82.
Haselman, Timothy J. 00A546380-85 Suspended1310 Catalina Avenue, #215 indefinitely effectiveRedondo Beach, California 03/05/99.
Haskell, Robert 00A290450 Suspended12 Aqua Vista Drive, #291 00A290451 indefinitely effectiveSan Rafael, California 00A290452 4/22/96.
Haw, Tarek L.A. A39540 Suspended aka: Tarek Lofti-Aly-Elhaw Indefinitely effective2078 Scyene Way 12/01/03.Boise, Idaho
Hayes, Jude R., M.D. 00C204270 Suspended 590 W. Putnam Avenue 00C204271 indefinitely effectivePorterville, California 10/25/85.
Hayes, Sidney J. 00C340040 Suspended61651 29 Palms Highway indefinitely effectiveJoshua Tree, California 7/29/96.
Heather, Loren 00C144700 Suspended1310 W. Stewart Drive, 00C144701 indefinitely effectiveSuite 601 CGP056530 8/23/96.Orange, California .
Heckelman, Barry 00A310680 Suspended2490 Black Rock, Suite 322 indefinitely effectiveFairfield, Connecticut 8/5/94.
Heffernon-Newbreast, 00G812590 SuspendedWanda June indefinitely effective3006 Hull Drive 6/14/01.Richmond, California
Hefty, Steven L. 00A480900 Suspended1062 Broadway Avenue indefinitely effectiveOttosen, Iowa 11/21/96.
Heilbrunn, Howard Irving G24139 Suspended5423 Fremontia Lane indefinitely effectiveSan Diego, California 10/10/02.
Heiss, Richard J. G29342 Suspended500 Old River Road, Suite 110 indefinitely effectiveBakersfield, California 3/1/02.
1 – Medi-Cal Suspended and Ineligible Provider ListSeptember 2007
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Physician ProviderNumber
Hemela, Katherine G. A42074 Suspended3178 Sunset Hills indefinitely effective Boulevard 7/11/2005.Thousand Hills, California and1300 West Gonzales Road,Suite #102Oxnard, California
Hendricks, Franklin, M.D. 000G26540 Suspended173 North Redwood Avenue 000G26541 indefinitely effectiveSan Jose, California 9/1/78.
Henriques, Gavin A. A62781 Suspended8631 West 3rd Street, indefinitely effective#1125-E 11/4/01.Los Angeles, California
Hepner, Gershon 00A308850 Suspended 1561 Reeves Street indefinitely effectiveLos Angeles, California 3/31/95.
Herbets, Steven 00G394760 Suspended1231 S. Harbor Boulevard indefinitely effectiveLa Habra, California 1/16/97.
Heric, Thomas M. A22944 Suspended13252 Hawthorne indefinitely effective Boulevard, Suite #100 10/19/2006.Hawthorne, California
Hering, Norton Suspended3 Harbor Ridge Drive indefinitely effectiveNewport Beach, California 4/2/97.
Herman, Stephen 00A202340 Suspended9341 Hazel Circle indefinitely effectiveVilla Park, California 4/26/91.
Herrera, Henry R. 00G316520 Suspended115 Countess Drive indefinitely effectiveWest Henrietta, New York 8/28/95.
Herrera, Jose A., M.D. 00A162780 Suspended517 16th Street indefinitely effectiveSacramento, California 5/7/90.
Herrero, Brunildo A. 00C424150 Suspended1600 Lakeland Hills indefinitely effective Boulevard 12/15/91.Lakeland, Florida
Herrero, Brunildo A. 00C424150 Suspended225 Dickinson Street, #H201 indefinitely effectiveSan Diego, California 12/15/92.
Physician ProviderNumber
Hershey Clinic Medical A29913 Suspended Group indefinitely effective780 East Romie Lane 03/07/03.Salinas, California and323 North Sanborn Road, Suite CSalinas, California and33 Iris DriveSalinas, California and1332 Natividad Road, Suite CSalinas, California
Heuler, Walter K. G32048 SuspendedP.O. Box 7016 indefinitely effectiveOrange, California 12/3/01.
Heywood, James R. 00A248770 Suspended2055 Orion indefinitely effectiveTempe, Arizona 12/7/95.
Hibbert, Harold H. Suspended373 River Oaks Circle, indefinitely effectiveApartment 304 10/19/00.San Jose, California
Hicks, James T. G11330 Suspended50 Buck Run Road indefinitely effectiveP.O. Box 177 2/21/01.Frenchville, Pennsylvania
Hignell, Thomas 00A348370 Suspended809 Arbutus Avenue indefinitely effectiveChico, California 9/30/94.
Hilde, Reuben Lynn, Jr. G22770 Suspended aka: Hilde, Lynn Jr. indefinitely effective7957 South Painter Avenue 12/4/02.Whittier, California
Hildebrand, John Francis C35182 Suspended9410 Elk Grove-Florin Road indefinitely effectiveElk Grove, California 5/30/01.
Hillyard, William T. 00A289810 Suspended5945 Brockston Avenue indefinitely effectiveRiverside, California 9/14/01.
1 – Medi-Cal Suspended and Ineligible Provider ListSeptember 2007
susp A24Physician Provider
Number
Hinshaw, Edward A. A43142 Suspended dba: Hinshaw, Draa, indefinitely effective March, Still & Hinshaw 12/13/01.12901 Saratoga AvenueSaratoga, California
Hirsch, Bernard H. 00C274820 Suspended1906 18th Street, #30 CGP067970 indefinitely effectiveBakersfield, California 4/20/99.
Hirsch, Michael Alan 00C347970 Suspended2308 Fortuna Court indefinitely effectiveDavis, California 1/12/01.
Hitt, Russell Scott G56312 Suspended2137 Trently Lane indefinitely effectiveBeverly Hills, California 03/22/04. and6041 Cadillac AvenueLos Angeles, California
Hmura, Michael S. 00G239830 Suspended6333 Wilshire Boulevard, indefinitely effective Suite 502 2/15/94.Los Angeles, California
Ho, Richard 00G385040 Suspended4585 Stevens Creek 00G385041 indefinitely effective Boulevard, #200 3/15/97.Santa Clara, California
Hocker, Don B. 00A178070 Suspended20933 Devonshire Street, indefinitely effective Suite 101 5/20/93.Chatsworth, California
Hodges, Robert M., M.D. 000G11770 Suspended3720 Hampton indefinitely effectivePasadena, California 6/21/83.
Hoffman, Sim Carlisle G43636 Suspended585 South Knott Avenue indefinitely effectiveAnaheim, California 01/22/04.
Holbrook, Julius C. 00A146400 Suspended3721 Sunset Lane, indefinitely effectiveSuite 107 2/17/92.Antioch, California
Holden, Edward, M.D. 00G262890 Suspended3736 Atlantic Avenue, #4 indefinitely effectiveLong Beach, California 3/6/91.
Hogen, Victor S. 13117 Suspended18433 Roscoe Boulevard, indefinitely effective#204 12/31/2006.Northridge, California
Holliman, Daniel 00G716170 Suspended579 Highway 49, Route 1 indefinitely effectiveSan Andreas, California 5/13/94.
Physician ProviderNumber
Hollis, Vincent C41324 Suspended Wentworth III indefinitely effectiveP.O. Box 50 6/28/02.Lake Arrowhead, California
Holloman, John D. 24131 Suspended1425 S. Main Street indefinitely effectiveWalnut Creek, California 1/31/2007. and500 Mountain ViewSan Luis Obispo, California
Holloway, Nathaniel L., Jr. 00G708590-1 Suspended5444 Shenandoah Avenue indefinitely effectiveLos Angeles, California 02/20/00.
Holnes, Herbert A., M.D. 00A147850 Suspended318 25th Street indefinitely effectiveSan Diego, California 12/19/88.
Hopkins, Darrel Suspended10721 Peony Circle indefinitely effectiveFountain Valley, California 12/20/98.
Hopp, Mark, M.D. 00A202820 Suspended6427 Edinger Avenue indefinitely effectiveHuntington Beach, California 12/9/92.
Horowitz, Melvin, M.D. 00C176400 Suspended4202 Genesee Avenue, #306 indefinitely effectiveSan Diego, California 10/31/74. Clairmont Anesthesia ZZZ43637Z Physician’s Medical Group
Horvath, Charles N. 00C291460 Suspended1930 Peyton Road 00C291461 indefinitely effectiveLa Verne, California 7/17/96.
Howard, Ronald M. 00G384470 Suspended11234 Anderson & Barton indefinitely effectiveLoma Linda, California 10/14/92.
Hubbard, Derick S. 69055 Suspended445 S. Figueroa Street, indefinitely effective#2600 8/23/2007.Los Angeles, California and234 S. Figueroa Street, #425Los Angeles, California and2220 E. Anaheim StreetLong Beach, California and11200 Wilmington AvenueLos Angeles, California
1 – Medi-Cal Suspended and Ineligible Provider ListOctober 2007
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Physician ProviderNumber
Hubbell, David V. A15713 Suspended10800 Paramount Boulevard, indefinitely effectiveNo. 406 02/11/03.Downey, California
Hufnagel, Vicki Georges 00G354720 Suspended1060 Hanley Avenue indefinitely effectiveLos Angeles, California 9/20/99.
Hughes, Donald Duane C39856 SuspendedNo. 13896876 indefinitely effectiveTDCJ-Wynne Unit 5/20/2007.Huntsville, Texas
Huling, John Jr., M.D. 00C242920 Suspended9902 South Compton indefinitely effectiveLos Angeles, California 1/7/77.
Hunt, Joseph, M.D. 00C268400 Suspended1835 El Cajon Boulevard indefinitely effectiveSan Diego, California 5/4/91.
Hurd, Steven Morris 00G411870 Suspended160 Country Club Drive, GR0011510 indefinitely effectiveSuite B 4/20/01.South San Francisco, California
Husain, Zafarul 00A352590 Suspended1849 Breckrinridge Circle 00A352591 indefinitely effectiveCorona, California 8/19/99.
Huthsteiner, George W. 00C138190 Suspended4537 Gable Drive 00C138191 indefinitely effectiveEncino, California 7/5/88.
Hutson, Edward E. 00C283890 Suspended35626 Linda Drive indefinitely effectiveFremont, California 10/20/99.
Hyman, Mark Howard G55008 Suspended10780 Santa Monica indefinitely effective Boulevard, Suite 408 3/1/03.Los Angeles, California
Hyman, Martin M. A19795 Suspended4545 Los Feliz Boulevard, indefinitely effective#310 12/16/03.Los Angeles, California and1505 North Edgemont StreetLos Angeles, California
Hymel, Bernard SuspendedP.O. Box 1000 indefinitely effectiveBoron, California 8/6/97.
Iacono, Robert Paul G40733 Suspended245 Terracina Boulevard, indefinitely effective#209A & #207B 9/19/2005.Redlands, California and11234 Anderson StreetLoma Linda, California
Physician ProviderNumber
Ibrahim, Albeer Ishak A44213 Suspended2625 West Alameda indefinitely effective Avenue, Suite #502 5/7/2007.Burbank, California and2651 S. Western AvenueLos Angeles, Californiaand16260 Ventura Boulevard,Suite #330Encino, California and11949 Vose StreetNorth Hollywood, California
Iconompolos, Byton, M.D. 00A309160 Suspended1479 Ygnacio Valley indefinitely effective Road, #2 9/12/84.Walnut Creek, California
Infante, Richard Stephen G46107 Suspended3005 West 58th Street indefinitely effectiveLos Angeles, California 08/31/04. and/orP.O. Box 94686Pasadena, California and/or1119 North Western AvenueLos Angeles, California and/or6011 Pacific Boulevard,Suite 123Huntington Park, California and/or217 North Main Street,Suite 115Santa Ana, California and/or335 H Street, Suite 205Chula Vista, California and/or1221 West Whittier BoulevardMontebello, California
Ingraham, Bette Ann 00C390470 SuspendedP.O. Box 1446 indefinitely effectiveTehachapi, California 3/11/96.
Innocent, George G., M.D. 00A075560 Suspended3875 Jackson Street, #5 ZZZ76031Z indefinitely effectiveRiverside, California ZZZ76032Z 9/21/83.
ZZZ59879Z
Ireton, William S., M.D. 000C60840 Suspended2915 Niles Street indefinitely effectiveBakersfield, California 9/6/78.
Issa, Adly Mansour 00A346030 Suspended1030 St. Johns Place indefinitely effectiveHemet, California 04/20/00.
1 – Medi-Cal Suspended and Ineligible Provider ListSeptember 2007
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Physician ProviderNumber
Izmirian, Thomas R., M.D. 020A22330 Suspended 26333 Western Avenue 00A283000 temporarily effective Lomita, California 6/2/77.
Jackson, Gregory Bernard, 00G475760 SuspendedM.D. indefinitely effective8943 S. Gramercy Place 4/5/1991.Los Angeles, California
Jackson, Sidney C., M.D. 000G23230 Suspended218 E Street indefinitely effectiveUnion City, California 3/31/1983. Medical Clinic of Union ZZZ31912Z City
Jacobs, Lawrence F., M.D. 00C198560 Suspended553 Hillside Drive indefinitely effectiveCloverdale, California 7/11/1989.
Jacobs, Ralph 000G20460 Suspended 227 Lucas Park Drive indefinitely effectiveSan Rafael, California 1/19/1996.
Jackson, D. Anthony G33174 Suspended aka: Jackson, Anthony indefinitely effective19004 Ivanpah Way 9/22/2005.Apple Valley, California and18300 Gridley Road, Suite #301Artesia, California
Jackson, George F. G9779 Suspended372 Arden Avenue, indefinitely effectiveSuite #102 8/19/2005.Glendale, California and2231 South Western AvenueLos Angeles, California and2300 South Hope Street,Suite #500ALos Angeles, California
Jackson, Oscar F. G48655 Suspended761 E. Sunny Hills Road indefinitely effectiveFullerton, California 4/3/02.
Jahangiri, Manour 00A286270 Suspended2156 Santa Fe 00A286271 indefinitely effective Los Angeles, California 5/14/93.
Jain, Kewel K. 00A365820 Suspended215 S. Lacienega, #201 indefinitely effectiveBeverly Hills, California 9/27/87.
Physician ProviderNumber
James, Dwight 00G402230 Suspended81-840 Avenue 46 00G402231 10/20/98Indio, California 00G402232 for 3 years.
00G402233
James, Edward V. 00PL21280 SuspendedP.O. Box 1392 00PL21281 indefinitely effectiveRancho Mirage, California 2/18/99.
Jandaghi, Mehidi 00C378750 Suspended27403 Country Glen Road indefinitely effectiveAguora Hills, California 1/20/98.
Janes, James Paul GFE006801 Suspended701 North Mobil Avenue, indefinitely effective#223 1/20/99.Camarillo, California
Jaqua, Richard A., M.D. 00C027160 Suspended909 Hyde Street, #608 indefinitely effectiveSan Francisco, California 6/24/91.
Jatana, Heidi Jo G68431 Suspended9400 Rosecrans Avenue indefinitely effectiveBellflower, California 09/05/03. and240 Juanita AvenueRedondo Beach, California and3400 Lomita Boulevard, Suite 501Torrance, California
Javidi, Kouchek 00A357760 Suspended13050 Tommydon Street indefinitely effectiveStockton, California 10/17/96.
Jazayeri, Mohamad A40092 Suspended aka: Jazayeri, Robert indefinitely effective1125 East 17th Street, 6/30/02.Suite W244Santa Ana, California
Jeanes, Lincoln Douglas 00G241860 SuspendedP.O. Box 50497 indefinitely effectiveJacksonville, Florida 4/15/96.
Jefferson, Michael 00G689030-1 Suspended4880 Llano Drive indefinitely effectiveWoodland Hills, California 01/18/01.
Jekot, Walter F. 00G149570-79 Suspended10732 National Boulevard indefinitely effectiveLos Angeles, California 11/21/00.
Jelderks, Robert M. 00C301650 Suspended501 Shell Beach Road, #A indefinitely effectiveShell Beach, California 05/09/00.
1 – Medi-Cal Suspended and Ineligible Provider ListSeptember 2007
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Physician ProviderNumber
Jellinek, Lawrence Roger G29482 Suspended1733 Loma Street indefinitely effectiveSanta Barbara, California 11/16/2006. and300 Hospital DriveVallejo, California
Jennings, Kenneth 00A179320 Suspended1273 Calle Marcus indefinitely effectivePalm Springs, California 9/20/94.
Jensen, Claudia J. C40810 Suspended8 North Fir Street indefinitely effectiveVentura, California 9/20/01.
Johanson, Craig Arthur 18148 Suspended3838 California Street, #816 indefinitely effectiveSan Francisco, California 6/27/2006. and1055 California Street, #1San Francisco, California
Johnson, Charles 00G692960 Suspended Lynnwood indefinitely effective691 Irolo Street, 12/17/99.Apartment 1108Los Angeles, California
Johnson, David 00C424630 Suspended4343 Terra Bella Place 00C424631 indefinitely effectiveOakland, California 00C424632 7/18/96.
Johnson, G. Nicholas C35219 Suspended3020 Bridgeway indefinitely effectiveSausalito, California 7/20/01.
Johnson, Harold J. 00G186830 Suspended939 Pacific Avenue, Apt. 12 indefinitely effectiveLong Beach, California 5/1/94.
Johnson, John L. A12856 Suspended300 South Beach indefinitely effective Boulevard 6/15/2005.La Habra, California and6725 Seville AvenueHuntington Park, California and2680 Saturn Avenue,Suite #200Huntington Park, California and504 South Sierra Madre BoulevardPasadena, California
Johnson, Kenneth G., III C30787 Suspended66815 5th Street indefinitely effectiveDesert Hot Springs, California 8/17/04.
Johnson, Kent R. G65573 Suspended6969 Brockton Avenue, Suite B indefinitely effectiveRiverside, California 1/17/02.
Johnson, Philip K. 00A190770 SuspendedP.O. Box 370 indefinitely effectiveBellflower, California 8/11/94.
Johnson, Richard K. Suspended107 South Locust Street indefinitely effectiveInglewood, California 10/19/00.
Physician ProviderNumber
Johnson, Sidney 00C298910 Suspended 5205 Wavecrest Way indefinitely effectiveOxnard, California 9/27/94.
Johnson, Willie Lee G84518 Suspended1800 North New Hampshire indefinitely effective Avenue, #139 11/6/02.Los Angeles, California
Jolly, Michael James, M.D. 00G595690 Suspended7087 N. Thorne Avenue indefinitely effectivePinedale, California 5/30/91.
Jones, Aaron Wilson A80253 Suspended43563 State Highway 299 indefinitely effectiveFall River Mills, California 11/18/2005.
Jones, Richard E. 000G42780 Suspended810 Altos Oaks Drive indefinitely effectiveLos Angeles, California 8/16/95.
Josef, Avelino S. 00A346590 Suspended1741 Pacific Avenue indefinitely effectiveLong Beach, California 8/20/98.
Juarez, Jesus R. Suspended2105 N. Cornelia indefinitely effectiveFresno, California 11/20/97.
Julian, Alexander A49823 Suspended1408 California Street, #309 indefinitely effectiveSan Francisco, California 3/6/01.
Julian, James J., M.D. 00A281870 Suspended2688 W. Imperial Hwy 020A21090 indefinitely effectiveInglewood, California ZZZ70551Z 2/21/86.
ZZZ70552ZZZZ70553ZZZZ70554ZZZZ70292ZZZZ70293Z
Justen, Jerome William C17333 Suspended801 E. Chapel Street indefinitely effectiveSanta Maria, California 7/8/02.
Kafi, Alex A37328 Suspended aka: Kafi, Abbas indefinitely effective2021 Bloomfield Woods Court 03/21/03.West Bloomfield, Michigan
Kahane, Lior Suspended10987 Bluffside Drive, indefinitely effective#4210 4/20/04.Studio City, California
Kamrava, Sid A34548 Suspended aka: Tarzana Garden indefinitely effective OB/GYN Laboratory 3/20/05.18411 Clark Street, #301Tarzana, California
1 – Medi-Cal Suspended and Ineligible Provider ListOctober 2007
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Physician ProviderNumber
Kang, Raymond Y., M.D. 00G427430 Suspended3544 West Olympic Boulevard indefinitely effectiveLos Angeles, California 1/31/91.
Kapen, Harold, M.D. 00C037628 Suspended12440 Firestone Boulevard, indefinitely effective#101 6/24/91.Los Angeles, California
Kaplan, Herbert A. 00G186950 Suspended9911 West Pico Boulevard, indefinitely effective#1270 07/17/00.Los Angeles, California
Kaplan, Mark 00A359930 Suspended8624 Santa Monica indefinitely effective Boulevard 8/19/95.Los Angeles, California
Kappeler, Thomas R., M.D. C34424 Suspended1100 Glendon Avenue, indefinitely effectiveSuite 2025 05/12/04.Westwood, California and2472 Chambers Road,Suite 250Tustin, California and412 31st StreetNewport Beach, California and1307 W. 105th StreetLos Angeles, California and1259 W. Manchester AvenueLos Angeles, California
Karalis, George D., M.D. 00A244120 Suspended235 El Camino Del Mar 00A244121 indefinitely effectiveSan Francisco, California 3/1/88.
Karalla, Mark 39792 Suspended18370 Burbank Boulevard, indefinitely effective#209 1/24/2007.Tarzana, California
Karefa-Smart, Suzanne 00G577920 Suspended aka: Karefa-Johnson, 00G577921 indefinitely effective Suzanne 00G577922 4/12/96.7004 Oxford DriveCypress, California
Karel, Jan 00G340790 Suspended8241 Broadway, #125 indefinitely effectiveLemon Grove, California 6/7/99.
Karger, Robert 000G60460 Suspended1312 Santa Rosa Street indefinitely effectiveSan Luis Obispo, California 5/30/94.
Physician ProviderNumber
Karpman, Beverly A. G37677 Suspended2021 Santa Monica indefinitely effective Boulevard, Suite #500E 1/4/2006.Santa Monica, California
Kato, Charles, M.D. 00G109420 Suspended1702 W. Temple Street indefinitely effectiveLos Angeles, California 7/7/90.
Kats, Bernhard Albert XPY070070 Suspended28 Stegecoach Road indefinitely effectiveAmherst, New York 07/28/00.
Katz, Steven Lawrence, M.D. G71332 Suspended 1700 California Street, indefinitely effectiveSuite #570 3/20/06. and1001 Potrero Avenue,Room 6DSan Francisco, California
Kaufman, Andrea Vita G51317 SuspendedThe Carriage House indefinitely effective110 Whitney Avenue 9/28/04.New Haven, Connecticut
Kawesch, Glenn A. 00G579030 Suspended9834 Genesee Avenue, 00G579031 10/21/97Suite 105 00G579032 for 4 years.La Jolla, California 00G579033
00G57903400G57903500G57903600G57903700G579038
Kay, Burns W. 00A307850 Suspended941 S. Atlantic Boulevard, indefinitely effective#103 11/18/88.Monterey Park, California
Kay, Starling E., M.D. 00C291890 Suspended424 Clark Drive indefinitely effectiveVallejo, California 8/28/90.
Kayne, Mark D. 50792 Suspended24355 Lyons Avenue, #230 indefinitely effectiveNewhall, California 12/3/2006.
Keehan, Michael F. G18940 Suspended15330 La Subida Drive indefinitely effectiveHacienda Heights, California 3/8/02.
Kees, Philip A. 00G517590 Suspended1701 N. Palm Canyon Drive, indefinitely effective#8 2/7/92.Palm Springs, California
Kelley, William T. 00G187280 Suspended248 Saint Francis Street indefinitely effectiveSan Gabriel, California 10/8/97.
1 – Medi-Cal Suspended and Ineligible Provider ListOctober 2007
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Physician ProviderNumber
Kemp, Ralph A. 00A214820 SuspendedP.O. Box 2727 00A214821 indefinitely effectiveAptos, California 3/19/98.
Kenyon, Keith E. A17050 Suspended14430 Hamlin Street, #C indefinitely effectiveVan Nuys, California 3/21/00.
Kerwood, Robert I. A29042 Suspended64 Grand Avenue indefinitely effectiveOroville, California 6/23/2005. and3 Court StreetWoodland, California
Khan, Farah Fauzia 00A413840 SuspendedP.O. Box 112 indefinitely effectiveCorte Madera, California 05/11/00.
Khan, M. Ibrahim C41598 Suspended10540 Wilshire Boulevard indefinitely effectiveLos Angeles, California 9/15/2005. and4455 West 117th StreetHawthorne, California
Khan, Nasim Hasan A52213 Suspended1629 West 17th Street, #B indefinitely effectiveSanta Ana, California 01/05/04. and115 East Washington BoulevardLos Angeles, California and1919 North Fairview Street,Suite 211Santa Ana, California
Khatibloo, Matthew Saeed A39389 Suspended11100 Warner Avenue, indefinitely effective#218 6/30/2006.Fountain Valley, California and951 South Beach BoulevardLa Habra, California
Khoury, Nicholas 00G285750 Suspended5975 E. Butler indefinitely effectiveFresno, California 8/19/96.
Kieler, George E. A19144 SuspendedBox 545 indefinitely effectiveRoscommon, Michigan 09/26/03.
Kim, Jeffrey S. A28958 Suspended841 Kirkwood Lane indefinitely effectiveLa Habra, California 5/10/01.
Kim, Joong Tai 00C406770 Suspended808 Greenridge Drive indefinitely effectiveLa Canada, California 10/8/97.
Physician ProviderNumber
Kim, Sang Ly Suspended1820 E. Plymouth Street indefinitely effectiveLong Beach, California 8/10/95.
Kim, Young 00A354280 Suspended5569 N. Country Road, #29 indefinitely effectiveLoveland, Colorado 3/17/95.
King, Phillip R. 00C250720 Suspended2530 Berryessa Road, 00C250721 indefinitely effective#253 11/20/97.San Jose, California
King, William S. A26006 Suspended12536 Pacato Circle North indefinitely effectiveSan Diego, California 10/26/98.
Kirkham, Dan R. G11339 Suspended17220 Newhope, No. 293 indefinitely effectiveFountain Valley, California 06/04/03.
Klvana, Milos 00A297190 Suspended24456 1/2 Lyons Avenue 00A297191 indefinitely effectiveNewhall, California 5/3/90.
Knapp, David Paul G33943 Suspended dba: El Centro Dermatology indefinitely effective Medical Corp. 08/21/01. Hanford & Valley Dermatology Medical Clinic214 Avenida CortezSan Diego, California
Knapp, Rebecca Ann A29994 Suspended aka: Garza, Rebecca indefinitely effective Uribe 3/26/04.118 Songbird LaneLaredo, Texas
Knight, Adrienne Evangeline G78549 Suspended aka: UCIMC indefinitely effectiveDepartment of Anesthesiology 12/11/03.101 City Drive, South RT #81AOrange, California and101 City Drive, SouthOrange, California
Knight, James W. 00C183940 Suspended535 E. Romie Lane, 00C183941 indefinitely effectiveSuite 10 3/6/97.Salinas, California
1 – Medi-Cal Suspended and Ineligible Provider ListSeptember 2007
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Physician ProviderNumber
Knight, Robert 00E23280 Suspended902 Coriente Point Drive 00E23281 indefinitely effectiveRedwood City, California 10/1/97.
Kobashigawa, Ted H. 00A393250 Suspended 7575 E. Southgate Drive, indefinitely effectiveNo. 107 8/20/98.Sacramento, California
Kogan, Israel G26696 Suspended2405 Eye Street N.W. indefinitely effectiveWashington, DC 3/15/02.
Kolen, Errol Robert A78918 Suspended505 Parnassus Avenue indefinitely effectiveSan Francisco, California 2/7/03.
Koningh, John Francis DC-15274 Suspended3919 Westerby Place, indefinitely effective Suite 101 06/23/04.Newport Beach, California and1600 Dove Street, Suite 200Newport Beach, California
Konrad-Piala, Julia D. G68035 Suspended927 Santa Ana Boulevard indefinitely effectiveOakview, California 11/5/01.
Kooker, Robert Allen 00G322360 Suspended3835 North Lakeshore indefinitely effective Boulevard 07/28/00.Loomis, California
Koonin, Alfred J. 00A298740 Suspended1125 S. Beverly Drive, #515 indefinitely effectiveLos Angeles, California 11/20/91.
Kooshian, George 00G412470 Suspended for12062 Valley View Street, 00G412471 30 days effectiveSuite 129 00G412472 10/10/95.Garden Grove, California
Kormi, Touraj, M.D. A48807 Suspended2160 Appian Way, indefinitely effectiveSuite #202 8/19/04.Pinole, California
Physician ProviderNumber
Korol, George Walter 00G470400 Suspended17541 Irvine Road indefinitely effectiveTustin, California 4/20/99.
Koser, William J. 00A116550 Suspended1402 Solano Avenue indefinitely effectiveAlbany, California 10/21/94.
Kotlewaki, George 31227 Suspended8349 Black Walnut Drive indefinitely effectiveEast Amherst, New York 3/28/2007. and3320 N. Los Coyotes DiagoLong Beach, California
Kovelman, Rozalia 00A416430 Suspended7531 Santa Monica indefinitely effective Boulevard, Suite 202 03/27/00.Los Angeles, California
Kowan, Joel M., M.D. 00A280210 Suspended4477 Whittier Boulevard indefinitely effectiveLos Angeles, California 3/26/91.
Kramer, Raymond Davies 48896 Suspended2 West Fern Avenue indefinitely effectiveRedlands, California 3/30/2005. and1730 JacksonSan Diego, California
Kraft, Robert 00C173970 License revoked780 Sodora Street effective Ukiah, California 7/11/86.
Kravatz, Arnold 00G133040 Suspended14508 Valley Vista Boulevard indefinitely effectiveSherman Oaks, California 3/24/95.
Krikorian, Krikor A44310 Suspended1220 South Central Avenue, indefinitely effectiveSuite #205 10/21/2004.Glendale, California and660 West BroadwayGlendale, California
Krosnoff, John Alexander CFE Suspended610 North Central Avenue, 30238 indefinitely effectiveSuite 301 03/24/04Glendale, California
1 – Medi-Cal Suspended and Ineligible Provider ListOctober 2007
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Physician ProviderNumber
Kruglick, Lewis John 00G484750 SuspendedP.O. Box 60 2/20/00Salinas, California for 10 years.
Kumar, Narendra, M.D. 00A343780 Suspended2917 Middleboro Place indefinitely effectiveModesto, California 12/6/90.
Kumpel, Friedrich 00A232360 Suspended1425 Main Street indefinitely effectiveDelano, California 12/7/94.
Kunihira, Dale Y. 00G591370 Suspended2618 Flint Way, #252 indefinitely effectiveSan Bernardino, California 2/14/94.
Kupferschmidt, Wm. O., 00A335370 SuspendedM.D. GR0028500 indefinitely effective11865 Inglewood Avenue GR0029220 7/8/91. (old date)Hawthorne, California
Kupferschmidt, William 33537 Suspended2525 S. San Pedro Street indefinitely effectiveLos Angeles, California 3/28/2007. (new date) and11895 Inglewood AvenueHawthorne, California
Kuron, Ralph G. A-39928 Suspended600 West Beverly indefinitely effective Boulevard, Suite #C 7/20/2006.Montebello, California
Kustek, Alane Marie Miller Suspended1849 Sawtelle Boulevard, indefinitely effective#660 5/20/98.Los Angeles, California
Kutzner, Robert R. 00G524830 Suspended3311 Drake Drive 00G524831 indefinitely effectiveSanta Maria, California 00G524832 2/21/96.
Kwong, Owen, M.D. 00C172570 Suspended1029 North Broadway indefinitely effectiveLos Angeles, California 9/30/77.
L’Ardent, Dennis R. 00G314870 SuspendedP.O. Box 71137 indefinitely effectiveLas Vegas, Nevada 8/31/95.
Labayen, Roberto F. 00A423800 SuspendedLuis Maria Campos 152-3B 00A423801 indefinitely effective1425 Buenos Aires, 00A423802 10/20/99.Argentina 00A423803
Physician ProviderNumber
Lahiri, Sunil R. 00A263360 Suspended525 34th Street indefinitely effective3811 River Boulevard 00A263361 5/15/92.Bakersfield, California
Lake, Alan Shanley 00G318640-41 Suspended383 Redondo Avenue, indefinitely effectiveApartment 3 07/24/00.Long Beach, California
Lake, Stephen CFE31281 Suspended9987 Reevesbury Drive indefinitely effectiveBeverly Hills, California 3/19/02.
Lakner, George Stephen CT23364 Suspended11201 Benton Street, DC16011 indefinitely effectiveSuite 116A IL77045 12/19/01.Loma Linda, California PK26288
MD25404MA50841NV8744NH9679NJ41726NY144504VA40690PA42384
Lambert, Paul W., M.D. 00C164390 Suspended619 Diagonal 00C164391 indefinitely effectiveClarkston, Washington 9/7/95.
Landau, Allyn Beth Suspended260 Stockton Street indefinitely effectiveSan Francisco, California 11/20/97.
Landman, George F., D.O. Suspended4752 Palm Avenue, #104-105 indefinitely effectiveLa Mesa, California 8/11/91.
Landry, Abner Martin III A44973 Suspended106 Harbor View Lane indefinitely effectiveLargo, Florida 05/15/03.
Lange, Dennis Andrew G75237 Suspended1600 East Third Avenue, indefinitely effectiveSuite 3103 11/11/04.San Mateo, California and1475 Huntington Avenue, Suite 201South San Francisco, California
Lara-Fuller, Adrienne Suspended2310 Laurel Valley Place indefinitely effectiveOxnard, California 2/2/2006.
Lark, David Lee 00G307190 SuspendedP.O. Box 128 00G307191 indefinitely effective1001 Van Dorsten Avenue 3/18/99.Corcoran, California
Larkin, David C40016 Suspended3592 Thor Avenue indefinitely effectiveLos Alamitos, California 10/4/02.
1 – Medi-Cal Suspended and Ineligible Provider ListOctober 2007
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Physician ProviderNumber
Lasko, Keith 00A301650 Suspended6900 Van Nuys Boulevard, indefinitely effective Suite 8 1/22/92.Van Nuys, California
Lasko, Keith Alan 00A301650 Suspended2421 W. Pratt Boulevard indefinitely effectiveChicago, Illinois 1/3/94.
Lassa, Ralph Edward CGP066735 Suspended1210 Sonoma Avenue, 00G252970 indefinitely effectiveSuite A 00G252971 8/20/98.Santa Rosa, California 00G252972
Lassoff, Irving 00A279700 Suspended8915 S. Broadway indefinitely effectiveLos Angeles, California 4/24/90.
Lauer, James Ward G20834 Suspended2067 Coyote Court indefinitely effectiveGrand Junction, Colorado 04/04/00.
Lauersen, Niels Helth C37842 Suspended784 Park Avenue indefinitely effectiveNew York, New York 10/20/00.
Lauron, Felix Ramiro A35809 Suspended14942 Riverside Drive indefinitely effectiveApple Valley, California 11/15/02.
Lavigne, Jeffrey E. 00G264590 Suspended9985 Sierra Avenue indefinitely effectiveFontana, California 10/15/92.
Lawrence, George S. A20116 Suspended786 Haight Street indefinitely effectiveSan Francisco, California 05/21/03. and931 Geneva AvenueSan Francisco, California and301 Niagara AvenueSan Francisco, California
Lawson, David G. A41446 Suspended215 S. Power Road, indefinitely effectiveSuite 106 5/4/00.Mesa, Arizona
Lawson, Donald A. XPY108390 Suspended550 West Thomas Road indefinitely effectivePhoenix, Arizona 5/20/96.
Lawton, Michael 00A419980 Suspended117 W. Anaheim Street indefinitely effectiveWilmington, California 7/19/92.
Lazaro, Dionisio 00A485120 Suspended Dumbrique 00A485121 indefinitely effectiveGood Shepherd Medical 00A485122 10/21/97. Clinic1444 Glengarry RoadLong Beach, California
Physician ProviderNumber
Leader, Harold 00C165720 Suspended27400 Hesperian Way indefinitely effectiveHayward, California 6/2/87.
Leader, William O. 00A411250 Suspended822 N McCadden Place 00A411251 indefinitely effectiveLos Angeles, California 6/27/01.
Lear, James Louis C38394 Suspended6032 South Brook Valley Way indefinitely effectiveLittleton, Colorado 11/10/03. and5350 Leetsdale DriveDenver, Colorado
Ledezma, David SuspendedGobemador Rico #210 indefinitely effectiveFrace Calette 09/20/00.Tijuana, Baja California
Lee, Anthony Tun A26677 Suspended1110 West La Palma indefinitely effective Avenue, #8 4/25/2006.Anaheim, California and501 South Brookhurst RoadFullerton, California
Lee, James Edward G66831 Suspended1915 Kent Drive indefinitely effectiveDavis, California 1/7/03.
Lee, Johng S. 00C416780 Suspended14600 Goldenwest Street, indefinitely effectiveSuite 206 12/12/95.Westminster, California
Lee, Mun Fa 00A217840 SuspendedP.O. Box 1515 indefinitely effectiveClearlake, California 7/26/96.
Lee, Nick Hung 00A612180 Suspended617 North Hildalgo Avenue indefinitely effectiveAlhambra, California 07/06/00.
Lee, Robert 59662 Suspended419 6th Avenue SW indefinitely effectiveRochester, Minnesota 10/2/2006.
Lee, Salvacion M. A45616 Suspended15 Sage Lane indefinitely effectiveBell Canyon, California 10/18/01.
Lee, Sun Kun A30787 Suspended12713 Queensborough indefinitely effectiveCerritos, California 10/9/01.
1 – Medi-Cal Suspended and Ineligible Provider ListSeptember 2007
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Physician ProviderNumber
Leftwich, James W. C16971 Suspended10061 Riverside Drive, #325 indefinitely effectiveToluca Lake, California 7/5/04. and4835 Van Nuys Boulevard,Suite #210Sherman Oaks, California and15333 Sherman Way,Suite #PVan Nuys, California
Lehmann, Lance J. G75590 Suspended425 Pinnacle Heights Lane indefinitely effectiveLas Vegas, Nevada 10/15/01.
Leiske, Willard W. 00A287420 Suspended41930 Garstin Road indefinitely effectiveBig Bear Lake, California 05/26/00.
Leiva, Daniel B., M.D. 00Al62110 Suspended20392 Town Center Lane indefinitely effectiveCupertino, California 6/17/76.
Lemes, Andrew John III C35646 Suspended2218 Cambridge Street indefinitely effectiveLos Angeles, California 05/15/03.
Lemons, Warren C. Suspended12012 Compton Avenue indefinitely effectiveLos Angeles, California 12/20/00.
Lemons, Warren Claudius A77928 Suspended aka: Lemons, John Warren indefinitely effectiveP.O. Box 300616 12/20/00.Houston, Texas
Lens, Robert 00AX42440 Suspended123 Leverington indefinitely effectivePhiladelphia, Pennsylvania 12/20/95.
Lepoff, Norman J. G37148 Suspended24953 Paseo de Valencia, indefinitely effectiveSuite 6-A 04/11/03.Laguna Hills, California
Leon, Margarita M. 00A315670 Suspended 67729 Sunrise Avenue, #800 days effectiveRoseville, California 12/28/91.
Leon, Victor Vicente A24607 SuspendedP.O. Box 211 indefinitely effectiveCovina, California 07/16/03. and420 West Rowland StreetCovina, California
Leonard, James J. 00C388730 Suspended372 W. Vernon Avenue indefinitely effectiveLos Angeles, California 1/5/89.
Physician ProviderNumber
Leone, Nelson 00G245380 Suspended 8154 La Mesa Boulevard 00G245381 indefinitely effectiveLa Mesa, California 00G245382 6/10/96.
Lerner, Albert, M.D. Suspended1509 Pebbleton Place indefinitely effectiveSanta Rosa, California 7/15/89.
Leslie, Robert A. 00C203080 Suspended9461 Grindlay Avenue 00C203081 indefinitely effectiveCypress, California 7/27/88.
Leslie, Robert A. 00C203080 Suspended265 Panorama 00C203081 indefinitely effectiveLaguna Beach, California 7/27/88.
Lesser, Leonard, M.D. 000C82630 Suspended1401 Avocado Ave., #603 000C82631 indefinitely effectiveNewport Beach, California 4/12/82.
Levinger, Ernest 000G23940 Suspended326 25th Avenue 000G23941 indefinitely effectiveSan Francisco, California 1/28/96.
Levitt, William Lawrence 00G309660 Suspended32 Tennis Club Drive indefinitely effectiveDanville, California 2/20/00.
Levy, Allen N., Jr., M.D. 00A172670 Suspended18448 Oxnard Street GR024930 indefinitely effectiveTarzana, California 4/30/89. Central Pathology Services Medical Group, Inc.
Levy, Jonathan Sandler G86671 Suspended1717 Centennial indefinitely effective Boulevard, Suite #6 10/14/2004.Springfield, Oregon and1110 18th StreetSpringfield, Oregon
Lew, Barry Gerald G34168 Suspended1530 South Street indefinitely effectiveLong Beach, California 2/6/02.
Lewis, Beverly G42697 Suspended2675 East Slauson Avenue indefinitely effectiveHuntington Park, California 05/19/03.
Lewis, Rayfield 00A109430 Suspended15413 Rockmead Court indefinitely effectiveHacienda Heights, California 10/20/99.
Lewter, Rufus, M.D. 00A213300 Suspended20615 Valley Boulevard 00A213301 indefinitely effectiveWalnut, California 4/18/85.
Li, Patrick P. 00G660430 Suspended6634 San Gabriel Boulevard indefinitely effectiveSan Gabriel, California 11/9/94.
1 – Medi-Cal Suspended and Ineligible Provider ListSeptember 2007
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Physician ProviderNumber
Liebman, William M. 00G128270-71 Suspended2620 Northgate Mall indefinitely effectiveSan Rafael, California 08/15/00.
Lieberman, Fred L., G8711 SuspendedM.D., Inc. indefinitely effective201 South Alvarado Street, 6/13/02.Suite 320Los Angeles, California
Liechti, Warner, M.D. 00C213170 Suspended3300 Webster Street, #202 indefinitely effectiveOakland, California 11/19/79.
Lightfoote-Young, Brenda A43548 Suspended315 P Street indefinitely effectiveEureka, California 12/05/02.
Lillo, Jose A. 00A367630 Suspended2020 N. Broadway, indefinitely effectiveSuite 105 9/16/96.Santa Ana, California
Lim, Ranulfo Y. 00A387190 Suspended1096 Southgate Avenue 00A387191 indefinitely effectiveDaly City, California XPY005950 8/20/98.Limpin, Juanita E. A22422 Suspended2800 Corabel Lane, #126 indefinitely effectiveSacramento, California 1/7/2007. and2403 San Gabriel BoulevardRosemead, California and12411 Slauson Avenue,Suite DWhittier, California and4255 Tyler AvenueEl Monte, California
Lin, Jang Bor 00A353290 Suspended232 East Monte Vista indefinitely effectiveVisalia, California 4/6/01.
Lin, Paul Pao-Shan 00G412330 Suspended8610 Sepulveda Boulevard, indefinitely effectiveSuite 207 06/19/00.Los Angeles, California
Lind, Myron 00G120220 Suspended4915 Tyrone Avenue, indefinitely effectiveApartment. 321 12/30/95.Sherman Oaks, California
Linden, Zena 000G49710 Suspended800 Pollard Road, Suite B207 indefinitely effectiveLos Gatos, California 6/28/94.
Lindquist, Charles G., M.D. Suspended502 S. Euclid Avenue #200 indefinitely effectiveNational City, California 6/19/91.
Physician ProviderNumber
Lipton, James E., M.D. 00C030240 Suspended9400 Brighton Way, #20 indefinitely effectiveBeverly Hills, California 8/30/90.
Liskanich, Michael J. 00AX42790 Suspended1521 Calle Cristina 020A4279D indefinitely effectiveSan Dimas, California 020A42790-93 07/20/00.
Liu, Samantha Landie 77884 Suspended415 N. San Mateo Drive, #3 indefinitely effectiveSan Mateo, California 4/9/2007.
Livingston, Virginia, M.D. 000C94430 Suspended3232 Duke Street ZZZ71245Z indefinitely effectiveSan Diego, California 3/29/86.
Lizarraga, Juan Fernando A49181 Suspended13409 Beach Street indefinitely effectiveCerritos, California 08/26/04. and/or3131 Santa Anita AvenueEl Monte, California and/or10512 Garvey AvenueEl Monte, California and/or13820 San Antonio DriveNorwalk, California and/or1568 West Sunset BoulevardLos Angeles, California
Lockyer, William A. 00A351940 SuspendedP.O. Box 790 indefinitely effectivePlymouth, California 11/18/99.
Lockhart, Alonzo Ellis C42439 Suspended708 East Manchester indefinitely effective Boulevard 08/04/04.Inglewood, California and2988 Jamacha RoadEl Cajon, California and1329 E. 1st StreetSanta Ana, California and719 E. 1st StreetSan Ana, California and1533 Alamitos Avenue, Suite BLong Beach, California
Loeb, Charles P. III G28182 Suspended4173 Mount Vernon Drive indefinitely effectiveLos Angeles, California 3/9/01.
Loeffler, Stacey Lee 00G694290 Suspended6220 San Fernando Road 00G694291 indefinitely effectiveGlendale, California 00G694292 10/20/95.
1 – Medi-Cal Suspended and Ineligible Provider ListSeptember 2007
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Physician ProviderNumber
Logan, Lloyd Q. 00A164470 Suspended1830 28th Street indefinitely effectiveBakersfield, California 07/07/00.
Lomalglio, Michael I., M.D 00A345550 Suspended146 Lyndon Street indefinitely effectiveHermosa Beach, California 9/22/83.
Lombardi, Luis Alejandro A52499 Suspended633 North Marine Avenue indefinitely effectiveWilmington, California 5/7/03.
Lonergan, Tad Emory 00A191560 Suspended1815 West Avenue #14 00A191561 indefinitely effectiveFullerton, California 4/8/91.
Long, John C., M.D. 00G495010 Suspended261 Alisal Road, #B indefinitely effectiveSolvang, California 12/3/90.
Long, Lester, Jr. G8808 SuspendedP.O. Box 1570 indefinitely effectiveLake Arrowhead, California 4/20/2006. and29099 Hospital Road,Suite #114Lake Arrowhead, California
Long, Walter K., M.D. 00C289070 Suspended3406 Maple Park Drive indefinitely effectiveKingwood, Texas 9/3/95.
Loo, Charles D. 00G248700 Suspended8460 Nuevo Avenue indefinitely effectiveFontana, California 7/15/92.
Loo, Charles D. 00G248701 Suspended601 W. County Line Road indefinitely effectiveClaimesa, California 7/15/92.
Loo, Charles D. 00G248702 Suspended279 W. Rialto Road indefinitely effectiveRialto, California 7/15/92.
Looney, Charles B. A41554 SuspendedP.O. Box 1411 indefinitely effectivePoint Reyes, California 12/29/2005. and599 Sir Francis Drake BoulevardGreenbrae, California and909 Hyde Street, Suite #115 San Francisco, California
Lopez, Steven 00G539130 Suspended917 Rome Drive indefinitely effectiveLos Angeles, California 6/29/95.
Lorenz, Martin F. G30797 Suspended2535 Camino Del Rio South, indefinitely effectiveSuite 150 09/17/03.San Diego, California
Physician ProviderNumber
Lotfy, Abdou Maged 49878 Suspended Micha indefinitely effective aka: Lotfy-Abdou, Maged 1/2/2007.3119 E. Genoa Street, DOntario, California
Lovalvo, Leonard, M.D. 00A206870 Suspended 907780 N. Fresno Street, #102 days effectiveFresno, California 8/22/91. (old date)
Lovalvo, Leonard J. 20687 Suspended7780 North Fresno Street, #101 indefinitely effectiveFresno, California 1/2/2007. (new date) and7780 North Fresno Street, #102Fresno, California
Lowinger, Paul L. 00C363300 Suspended 77 Belgrave Avenue 5/13/93San Francisco, California for 90 days.
Luh, Hsiou-Kuang A34977 Suspended11180 Warner Avenue, Suite 265 indefinitely effectiveFountain Valley, California 11/9/98.
Lundquist, Charles 00A121230 Suspended6186 Lambda Drive 11/5/91San Diego, California for 3 years.
Lusman, Jules Mark A47985 Suspended925 Westgate Avenue, indefinitely effectiveSuite 401 12/6/02.Los Angeles, California
Lyons, Lawrence 8848 Suspended435 Arden Avenue, indefinitely effectiveSuite #440 5/22/2006.Glendale, California and633 Warner AvenueLos Angeles, California
Macias, Martin SuspendedAV. Huajuco #17 indefinitely effectiveFrace Monterrey 09/20/00.Tijuana, Baja California
Mack, Ollie R., Jr. Suspended1659 Vallarta Circle indefinitely effectiveSacramento, California 9/20/01.
MacKay, Calvin R., M.D. 00C130960 Suspended771 Buschmann Road indefinitely effectiveParadise, California 8/31/91.
Mackey, Cynthia K. Suspended16 Quarterdeck Street, #201 indefinitely effectiveMarina Del Rey, California 12/9/96.
MacNeil, Donald J. 00G66850 Suspended1770 N. Orange Grove, Suite 107 indefinitely effectivePomona, California 8/1/94.
1 – Medi-Cal Suspended and Ineligible Provider ListOctober 2007
susp A36Physician Provider
Number
Madey, Edward 00C101410 Suspended22554 Ventura Boulevard indefinitely effectiveWoodland Hills, California 11/22/96.
Magbanua, Laurie F. A23946 Suspended16350 Filbert Street indefinitely effectiveSylmar, California 2/01/2007. and3871 Florista StreetLos Alamitos, California and21004 Nordhoff StreetChatsworth, California
Magnus, Vernon John G224380 Suspended1826 West Kettleman Lane, indefinitely effectiveSuite C 10/11/00.Lodi, California
Mahboubian, Sohail Sam Suspended4868 Adele Court indefinitely effectiveWoodland Hills, California 1/12/97.
Mahoney, Glen 00A282650 Suspended7442 Mount Joy Street indefinitely effective Huntington Beach, California 1/23/92.
Malabed, Leonilo L. A16847 Suspended145 Mountain Spring indefinitely effective Avenue 02/27/03.San Francisco, California
Maleki, Pejman A66636 Suspended1603 Reggio Aisle indefinitely effectiveIrvine, California 7/18/02.
Maloney, Calvin 00A149100 Suspended502 S. Euclid Avenue, indefinitely effectiveSuite 200 7/1/94.National City, California
Manthey, Russell C41884 Suspended1772-J Avenue De Los indefinitely effective Arboles, #148 2/3/03.Thousand Oaks, California
Manzur, Juan Esber G59934 Suspended1621 East Sahara Avenue indefinitely effectiveLas Vegas, Nevada 7/11/2005.
Physician ProviderNumber
Marangu, JeanAnn Makewa 00G747500 Suspended898 Temple Terrace, indefinitely effectiveApt. 323 10/10/93.Los Angeles, California
Marchbanks, Howard 00C200830 Suspended601 E. Whittier Boulevard, indefinitely effective#104 7/29/91.La Habra, California
Marcolesco, Robert G12171 Suspended12900 B Garden Grove indefinitely effective Boulevard, #138 8/17/05.Garden Grove, California andSepulveda Medical Clinic6813 Sepulveda BoulevardVan Nuys, California
Marcus, Mortimer 00A172200 Suspended9210 Colima Road, 00A172201 indefinitely effective Suite 107 4/15/95.Whittier, California
Margoles, Michael Stuart 00A239020 Suspended aka: Michael S. Margoles indefinitely effective4777 Corte DeCervato 10/20/99.San Jose, California
Marquez, Emilio, M.D. 00A223610 Suspended4055 Whittier Boulevard indefinitely effectiveLos Angeles, California 3/14/77.
Marshall, James A. 00A232200 Suspended1815 S. Second Street indefinitely effectiveArcadia, California 2/18/99.
Marshall, William E. Suspended1014 West Olive Avenue indefinitely effectiveBurbank, California 4/13/97.
Martell, Algis USA195220 Suspended129 West Sixth Street, FS4916324 indefinitely effective Suite 3 10/6/95.Reno, Nevada
Martin, Jeffrey T. 00C410890 Suspended1250 N. Avalon Boulevard indefinitely effectiveWilmington, California 10/22/93.
Martin, Larry A. 00A302250 Suspended5107 Waring Road indefinitely effectiveSan Diego, California 12/12/91.
Martin, Michael, M.D. Suspended440 West Goshen, Apt. 222 indefinitely effectiveVisalia, California 7/28/88.
Martin, Richard A., M.D. 00A225050 Suspended1999 Mt. Olive Drive indefinitely effectiveSanta Rosa, California 2/14/96.
1 – Medi-Cal Suspended and Ineligible Provider ListSeptember 2007
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Physician ProviderNumber
Martin, Roscoe 00A390170 Suspended aka: Roscoe B. Martin 00A390171 8/20/98 Roscoe Bernard Martin for 3 years.5337 37th Avenue, Suite 4Sacramento, California
Martina, John Gordon 00G333410 Suspended302 Madrone Avenue indefinitely effectiveLarkspur, California 05/18/00.
Martinez, Anthony, M.D. 00C152050 Suspended2188 South Atlantic 00C152051 indefinitely effective Boulevard 4/24/84.City of Commerce, California
Martz, Willard H. C26459 Suspended206 Saint Joseph Avenue indefinitely effectiveLong Beach, California 12/29/2005.
Mason, Arthur R. III A56233 Suspended25850 London Place indefinitely effectiveStevenson Ranch, California 1/16/02.
Massoud, Nidal, M.D. A61949 Suspended395 East O’Keefe Street, indefinitely effectiveApt. #4 05/20/03.East Palo Alto, California and3131 Browns Valley RoadNapa, California
Matalka, Victor 000G83730 Suspended1556 W. Del Amo Boulevard indefinitely effectiveTorrance, California 10/4/86.
Matalon, Ofer I. Suspended2250 Valley Place indefinitely effectiveSanta Rosa, California 5/6/97.
Mathews, Roger D. 00A209210-11 Suspended11332-097 indefinitely effective3705 West Farm Road 04/24/00.Lompoc, California
Matory, William E., Jr. C39810 Suspended250 East Yale Loop, Suite A indefinitely effectiveIrvine, California 6/18/98.
Matsuda, Kazuko Traci A50639 Suspended2665 30th Street, indefinitely effectiveSuite #204 9/1/2006.Santa Monica, California
Physician ProviderNumber
Matsumoto, Kenneth K. 00C161610 Suspended1399 South Roxbury Drive, YYY48524Y indefinitely effectiveSuite 100 05/11/00.Los Angeles, California
Maun, Lorenzo Payabyab C43091 Suspended23361 El Torro Road, Suite 105 indefinitely effectiveLake Forest, California 05/31/00.
May, Lance A. G84676 Suspended926 North Pearl Street, indefinitely effectiveD43 6/3/2005.Tacoma, Washington and1081 North China Lake BoulevardRidgecrest, California
McBay, Michael 00G637480 Suspended3956 Ingraham, #5 00G637481 indefinitely effectiveLos Angeles, California 00G637482 4/25/95.
McCann, David Michael G57396 Suspended4944 Sunrise Boulevard, indefinitely effectiveSuite #F 7/22/04.Fair Oaks, California and9480 Madison Avenue,Suite #2Orangevale, California
McCann, Gerald J. A21167 Suspended11741 E. Telegraph Road, indefinitely effectiveSuite G 3/20/02.Santa Fe Springs, California
McClanahan, Jeffrey S. G62238 Suspended100 Belgian Way indefinitely effectiveLos Gatos, California 8/25/2005. and20555 Prospect RoadCupertino, California
McClintock, John Scott G75194 Suspended432 Windrose Way indefinitely effectiveChula Vista, California 09/10/01.
McCombs, Martin B. Suspended2017 E. 4th Street indefinitely effectiveLong Beach, California 9/20/99.
1 – Medi-Cal Suspended and Ineligible Provider ListOctober 2007
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Physician ProviderNumber
McCormick, Thomas E. 00C195940 Suspended1044 Sir Francis Drake 00C195941 indefinitely effective Boulevard 10/31/96.Kentfield, California
McCuin, Jerome Ellis 00C362700 Suspended5199 E. Pacific Coast Hwy., 00C362701 indefinitely effective#330N 00C362702 10/14/93.Long Beach, California 00C362703
McFadden, Michael J. A18526 Suspended 4062 24th Street indefinitely effectiveSan Francisco, California 11/27/97.
McGregor-Myers, Myrna V. 79802 Suspended22444 Terrace Pines Drive, indefinitely effectiveApartment C 2/20/01.Grand Terrace, California
McGuire, Joseph Smith G69563 Suspended106 Peter Coutts indefinitely effectiveStanford, California 12/10/2004. and1350 Willow Road,Suite #202Menlo Park, California
Mclntosh, Abraham, M.D. 00C178690 Suspended5337 37th Avenue, #7 indefinitely effectiveSacramento, California 5/13/86.
License revoked.
McKenzie, Kenneth Ray 00C227480-81 SuspendedP.O. Box 1049 ZZZ80819Z indefinitely effectiveFreedom, California 05/18/00.
McKinney, Karen Fay G44077 Suspended3806 Brown’s Point indefinitely effective Boulevard 04/28/04.Tacoma, Washington
McKinnon, James A. 00C257920 Suspended2700 Garretson indefinitely effectiveCorona, California 3/18/99.
McKirdy, Arthur A., M.D. 00A210180 Suspended2395 Ocean Avenue indefinitely effectiveSan Francisco, California 9/22/83.
McKissock, Paul K. GFE4221 Suspended75280 Inverness Drive indefinitely effectiveIndian Wells, California 4/12/01.
McMahon, Joseph A. 00G499200 Suspended3617 S. Maple Avenue indefinitely effectiveLos Angeles, California 2/11/88.
Physician ProviderNumber
McNamee, Brian Francis G36713 Suspended4303 Virginia Drive indefinitely effectiveFairview Park, Ohio 08/04/03.
Mehrkhan, Hassan 00C391470 Suspended850 E. Latham Avenue indefinitely effectiveHemet, California 5/19/95.
Meltzer, Barnet G. G19625 Suspended1011 Camino Del Mar, #234 indefinitely effectiveDel Mar, California 9/19/02.
Member, Bernard Jere G52371 Suspended12335 South Anna Drive indefinitely effectiveRockville, California 08/09/02. and25825 Vermont AvenueHarbor City, California and455 South Main StreetOrange, California
Merlos, Joaquin J. TPY001060 SuspendedInmate #50840-198 indefinitely effectivec/o Bastrop FCI 09/20/00.P.O. Box 730Highway 95Bastrop, Texas
Mernick, Mitchell Harvey 10010 Suspended10 Waterside Plaza, indefinitely effectiveApartment 33J 07/13/00.New York, New York
Merriman, Edward 00C407880 Suspended63 Avon Hill Street indefinitely effectiveCambridge, Massachusetts 7/22/95.
Messer, Sidney, M.D. 000C62100 Suspended11704 Wilshire Boulevard indefinitely effectiveW. Los Angeles, California 2/27/87.
Michelson, David 00G319060 Suspended60 Walnut Avenue indefinitely effectiveLarkspur, California 3/14/87.
Middo, Robert T. G-5490 Suspended12203 Santa Gertrudes, #61 indefinitely effectiveLa Mirada, California 06/26/03.
Mighell, Scott J. 000G25940 Suspended6510 E. Spring indefinitely effectiveLong Beach, California 7/15/96.
Milea, Adrian V. A51493 Suspended3680 South 2700 East indefinitely effectiveSalt Lake City, Utah 12/6/01.
Miller, Bradley Suspended1800 S. Cochran Place indefinitely effectiveLos Angeles, California 4/23/97.
1 – Medi-Cal Suspended and Ineligible Provider ListSeptember 2007
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Physician ProviderNumber
Miller, Donald A., M.D. 000G95180 Suspended82-420 Miles Avenue ZZZ49862Z indefinitely effectiveIndio, California 9/23/85.
Miller, Glenn E. G54401 Suspended1335 State Street indefinitely effectiveSanta Barbara, California 7/17/02.
Miller, John Edward G52628 Suspended153 South Serrano Avenue indefinitely effectiveLos Angeles, California 02/20/03.
Miller, Malcolm G. 00A328530 Suspended2022 East 20th Street indefinitely effectiveSanta Ana, California 12/20/98.
Miller, Richard R. G12005 Suspended1300 Bancroft Avenue, indefinitely effectiveSuite #103 9/28/04.San Leandro, California
Milne, Peter L. 22289 Suspended6115 Olvera Court indefinitely effectiveChino, California 10/17/2006. and3221 Liberty BoulevardSouth Gate, California
Milton, Robert E. 00A192220 Suspended844 Hartnell indefinitely effectiveRedding, California 2/9/96.
Minaya, Jose, M.D. 00A241410 Suspended2010 Wilshire Boulevard 00A241411 temporarily effectiveLos Angeles, California 00A241412 8/13/84.
ZZZ77620ZZZZ77621ZZZZ77622ZZZZ77623ZZZZ78390ZZZZ78391Z
Minkowski, William Louis Suspended2395 Delaware Avenue, #66 indefinitely effectiveSanta Cruz, California 3/18/99.
Mintz, Leslie Joy G76917 Suspended140 Ramona Road indefinitely effectivePortola Valley, California 10/29/02.
Miofsky, Wiliam E., M.D. 00C212480 Suspended580 University Avenue indefinitely effectiveSacramento, California 12/21/80.
Mir, Jehan Zeb 24647 Suspended4455 Torrance Boulevard, indefinitely effective#330 1/5/2007.Torrance, California and3633 Martin Luther King, #1Lynwood, California and1360 W 6th Street, #125San Pedro, California and24065 Neece Avenue, #17Torrance, California
Physician ProviderNumber
Miro, Jose SuspendedBlvd. Sanchez Taboada #28 indefinitely effectiveZona Rio 09/20/00.Tijuana, Baja California
Mirrafati, Sayed J. A61772 Suspended4291 Pioneer Street indefinitely effectiveIrvine, California 10/18/01.
Misko, John C. C26843 Suspended501 North Graham indefinitely effectivePortland, Oregon 9/6/2005. and2800 North Vancouver Avenue, Suite #202Portland, Oregon
Mitchell, Ralph A. Suspended10451 Monte Vista Street indefinitely effectiveAlta Loma, California 4/6/97.
Mitts, Roger M., M.D. 00A104420 Suspended831 Gale Drive indefinitely effectiveCampbell, California 9/7/76.
Mladineo, John G21244 Suspended971 Lakeland Drive, #656 indefinitely effectiveJackson, Mississippi 4/4/2005. and1020 River Oaks Drive,Suite #300Jackson, Mississippi
Modilevsky, Leonid A40608 Suspended3742 Ballina Canyon Road indefinitely effectiveLos Angeles, California 5/22/00.
Mogensen, Thomas K. G79090 Suspended850 E. Washington Street indefinitely effectiveColton, California 1/22/03.
Moghtader, Mehran A62032 SuspendedP.O. Box 931376 indefinitely effectiveLos Angeles, California 1/8/03.
Mohalla, Aiman Nasser A53342 Suspended aka: Mohulla, Aiman indefinitely effective Solomon, David 10/01/03.6475 East Pacific Coast Highway, #109Long Beach, California
Moini, Kian 00A526170 Suspended17860 Newhope Street indefinitely effectiveFountain Valley, California 4/18/97.
Monroe, Byron Lee 000G257940 Suspended303 W. Ortega indefinitely effectiveSanta Barbara, California 5/13/94.
Mont, Hallie B. A12865 Suspended239 West Olive Avenue indefinitely effectiveBurbank, California 8/31/01.
1 – Medi-Cal Suspended and Ineligible Provider ListOctober 2007
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Physician ProviderNumber
Montazeri, Ata Oilah A38685 Suspended7218 Garfield Avenue indefinitely effectiveBell Gardens, California 1/20/02.
Monterice, Anu De 00G146470 Suspended680 East Cotati Avenue 00G146471 indefinitely effectiveCotati, California 00G146472 5/28/01.
00G146473
Moon, Chae Hyun A32120 Suspended15821 Texas Spring Road indefinitely effectiveRedding, California 9/20/2006. and 1555 East Street,Suite #100Redding, California and1450 Liberty StreetRedding, California
Moore, Edwin W. 00A487250 Suspended5101 E. Anaheim, #201 indefinitely effectiveLong Beach, California 6/1/95.
Moore, Thomas P. CFE19946 Suspended1 Groveourt indefinitely effectiveJacksonville, North Carolina 05/31/00.
Moore, William D. 00A160320 Suspended229 Glen Ridge Avenue 00A160321 indefinitely effectiveLos Gatos, California 2/3/95.
Moorehead, Will E., M.D. 00C330880 Suspended2299 Post Street GR0006250 indefinitely effectiveSan Francisco, California 3/12/85.
Moran, Jeffrey 00A338670-2 Suspended3035 Calle Frontera indefinitely effectiveSan Clemente, California 03/29/00.
Morantte, Bernardo, Jr. 00A305200 Suspended1524 McHenry Avenue, 00A305201 indefinitely effective#320 00A305202 10/21/96.Modesto, California 00A305203
Morrissey, William J. 00C152170 Suspended3647 40th Street indefinitely effectiveSacramento, California 2/1/89.
Morse, Howard T. 00A185470 Suspended30 Montgomery Court 00A185471 indefinitely effectivePort Ludlow, Oregon 00A185472 4/20/95.
Moses, Edwin D. 00G123490 Suspended416 W. McKinley 00G123491 indefinitely effectiveFresno, California 3/20/87.
Mosser, Robert Stanley 36586 Suspended2200 El Portal Drive, #6 indefinitely effectiveBakersfield, California 3/22/2007.
Motlagh, Frank A. 00A331350 Suspended5555 Reservoir Drive, indefinitely effectiveSuite 30 12/2/96.San Diego, California
Physician ProviderNumber
Mott, Joseph Abraham G78419 Suspended45 R Boardman Place indefinitely effectiveSan Francisco, California 04/28/04. and1414 South Hope StreeLos Angeles, California and400 East Main Street, Suite 200Stockton, California
Mulfinger, George A16984 Suspended39 Congress Street, indefinitely effectiveSuite 201 2/27/01.Pasadena, California
Munguia, Jose Angel SuspendedITR Aguas Calientes 2019-B indefinitely effectiveOtay Villareal 09/20/00.Tijuana, Baja California
Murphy, Monica A49186 Suspended Jeanne-Maria indefinitely effective828 South Oleander Avenue 03/17/03.Bakersfield, California
Musikant, David S. 00G454630 SuspendedHospital Road indefinitely effectiveHoopa, California 10/25/92.
Myers, George C. 00C360920 Suspended10526 S.E. 28th Street indefinitely effectiveBellevue, Washington 8/17/94.
Myers, Karen A Suspended268 Bush Street, #3041 Indefinitely effectiveSan Francisco, California 10/20/03.
Nachman, Roy 00G378980 Suspended12440 Firestone Boulevard indefinitely effectiveNorwalk, California 1/8/88.
Nadgir, Lakshmi 00C500650-5 Suspended114 South Oxford Avenue, indefinitely effective#103 10/10/00.Los Angeles, California
Namihas, Ivan 000G73130 Suspended14591 Newport Avenue, indefinitely effective#104 8/19/94.Tustin, California
Nathu, Rakesh Magan A70906 Suspended1722 Victory Boulevard indefinitely effectiveGlendale, California 06/23/04. and10409 Rocky Water AvenueLas Vegas, Nevada
1 – Medi-Cal Suspended and Ineligible Provider ListSeptember 2007
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Physician ProviderNumber
Navarro, John Matthew G83145 Suspended300 Pasteur Drive indefinitely effectivePalo Alto, California 3/25/2004. and2300 Deborah LaneEdmond, Oklahoma
Neff, Merlin Lee, Jr. A19918 Suspended14020 Golden Raintree indefinitely effectiveChino Hills, California 6/12/2006. and26520 Cactus Avenue,F2027Moreno Valley, California
Nelson, Donald G. 12127 Suspended2108 24th Street, #2 indefinitely effectiveBakersfield, California 6/30/2006. and2901 H Street, #9Bakersfield, California
Nelson, Gerald Eugene 00C317460 Suspended550 Lomas Sante Fe Drive, indefinitely effectiveApartment. U 12/14/00.Solana Beach, California
Nelson, James D. 00A129540 Suspended1701 27th Street indefinitely effectiveBakersfield, California 5/9/87.
Nelson, Ricky Joe G70300 Suspended12101 North Macarthur, #129 indefinitely effectiveOklahoma City, Oklahoma 3/1/01.
Nemeth, Irwin 020A33110 Suspended14 Saint Christopher Lane ZZZ78608Z indefinitely effectiveCoronado, California 06/20/00.
Nettl, Francis M. G61057 Suspended4070 Riviera Drive, #7 indefinitely effectiveSan Diego, California 7/5/01.
Neufeld, Otto John A9329 Suspended922 East Olive Avenue, #A indefinitely effectiveBurbank, California 9/16/2002 (Disabled). and633 North Central Avenue,Suite #104Glendale, California and1530 East Chevy Chase DriveGlendale, California
Newman, Lee David 000G70370-2 Suspended9436 Kirkside Road indefinitely effectiveLos Angeles, California 03/17/99.
Newport, Robert, M.D. 00A222110 Suspended150 Felker Street 00A222111 indefinitely effectiveSanta Cruz, California 1/26/84.
Physician ProviderNumber
Newsome, Eddie Leanders 00G257120 Suspended aka: Eddie Leanders 00G257121 indefinitely effective Newsome, III 4/20/98.273 29th StreetOakland, California
Nghiem, Thieu Lenh 00C409930 Suspended600 N. Euclid Street indefinitely effectiveSanta Ana, California 4/4/92.
Ngo, Trung T. 00A372750 Suspended6900 Van Nuys Boulevard 00A372751 indefinitely effectiveVan Nuys, California 7/1/88.
Nguyen, Chuong, M.D. 00A295980 Suspended5110 Westminister Avenue indefinitely effectiveSanta Ana, California 7/11/95.
Nguyen, Duc Qui 00A423020 Suspended711 S. Crown Point indefinitely effectiveAnaheim, California 1/22/97.
Nguyen, Hai Van A44145 Suspended4423 Walnut Street indefinitely effectiveOakland, California 12/16/03.
Nguyen, Hai Van 00A441450 Suspended16843 E. 14th Avenue indefinitely effectiveSan Leandro, California 7/20/99.
Nguyen, Henry Nghia-Hieu A36876 Suspended15569 Brookhurst indefinitely effectiveWestminster, California 4/2/03.
Nguyen, Kim Phan, M.D. 00G349030 Suspended1850 Trestle Glen Road indefinitely effectivePiedmont, California 6/28/91.
Nguyen, Mai Van Thi, M.D. 00A366690 Suspended8412 Pepperwood Circle indefinitely effectiveWestminister, California 4/8/88.
Nguyen, Thi V., M.D. 00A366690 Suspended5110 Westminister Avenue 00A366691 indefinitely effectiveSanta Ana, California 5/30/85.
Nguyen, Thuong Vu 00A329910 Suspended602 East Santa Clara Street indefinitely effectiveSan Jose, California 8/8/97.
Nguyen, Tri-Dang, M.D. 00A365370 Suspended12531 Harbor Blvd., #H indefinitely effectiveGarden Grove, California 12/6/90.
Nguyen, Xuan Truong, M.D. 00A383520 Suspended10550 Westminster Avenue indefinitely effectiveGarden Grove, California 3/12/85.
Nhu-Hy, Ha Thuc 00A385560 Suspended1720 Via Palerno indefinitely effectiveMontebello, California 4/15/87.
1 – Medi-Cal Suspended and Ineligible Provider ListSeptember 2007
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Physician ProviderNumber
Nickels, Russell A. 00C306750 Suspended415 Highland Avenue indefinitely effectiveSmith River, California 1/28/93.
Nickels, Russell A. USA208660 Suspended412 Alder Street indefinitely effectiveBrookings, Oregon 1/28/93.
Nilsson, Jerry D. 00C206400 Suspended12101 Dale, Space 33 indefinitely effectiveStaton, California 04/26/00.
Noel-Uyloan, Catherine 00A500850-51 Suspended5339 Vista Hermosa indefinitely effectiveCypress, California 11/16/00.
Noonan, Charles A. 00C370510-11 SuspendedSalvio Street, Suite 22 indefinitely effectiveConcord, California 06/23/00.
Nordell, Margaret Claire G67597 SuspendedP.O. Box 2188 indefinitely effectiveMinot, North Dakota 01/16/04. and120 Burdick Expressway E.Minot, North Dakota
Nordlund, Paul Clemens 00C321650 Suspended805 W. 57th Street indefinitely effectiveLos Angeles, California 1/4/92.
Norman, Dianna Lee G44226 Suspended6907-A Paradise Valley Road indefinitely effectiveSan Diego, California 11/2/02.
Norton, Jane Espejo G34784 Suspended74-133 El Paseo, Suite 6 indefinitely effectivePalm Desert, California 09/30/04. and8635 West 3rd Street,Suite 1150 WLos Angeles, California
Nourmand, Amir Daniel G80075 Suspended1448 Beverwil Drive indefinitely effectiveLos Angeles, California 02/26/03.
Novick, James S. C36874 Suspended aka: Novick, John S. indefinitely effective1816 Rosita Drive 11/14/01.Glendale, California
Nunez, Oscar Garcia G4790 Suspended21209 South Park Victoria Drive indefinitely effectiveMilpitas, California 9/3/01.
Nuval, Generosa Moreno A30265 Suspended1268 Hogan Avenue indefinitely effectiveBanning, California 04/17/03.
Physician ProviderNumber
Nwobi-Lazarus, Veronica Suspended2001 Santa Monica, #468-W indefinitely effectiveSanta Monica, California 2/12/95.
Nybe, E. Edward 000E10940 Suspended1840 N. Bristol indefinitely effectiveSanta Ana, California 7/7/95.
Oakes, Cecil Everett Jr. C43319 Suspended1701 Marshall Road 282 indefinitely effectiveVacaville, California 12/10/02.
OBrien, Arthur, M.D. Suspended21297 Foothill Boulevard, indefinitely effectiveSuite #101 4/20/2005.Hayward, California
Ocampo, Benjamin Paz A43105 Suspended101 Park Place indefinitely effective Boulevard, #1 04/20/00.Kissimmee, Florida
Oceguera, Antonio SuspendedCalle Sor Juana Ives de la Cruz, indefinitely effective#355, Los Altos 09/20/00.Tijuana, Baja California
O' Donnell, Joseph CFE41378 Suspended Edward, M.D. indefinitely effective2655 Jalna Lane 5/18/2006.Fallbrook, California
Ogunmola, Olufemi B. 00A263200 License revocation100 W. 64th Street 00A263201 effective 7/3/86.Inglewood, California
O'Hanlan, Katherine A. G70108 Suspended4370 Alpine Road, indefinitely effectiveSuite #4 6/11/2005.Pomona Valley, California
Oilschlager, Gerald Albert 000G65790 Suspended755 Obispo Avenue, Unit 1 000G65791 indefinitely effectiveLong Beach, California 000G65792 7/27/01.
000G65793000G65794000G65795000G65796
Okajima, Niles M. 00A285500 Suspended4075 Tweedy Boulevard indefinitely effectiveSouthgate, California 2/19/98.
Olaco, Julio Pangilinan 00A228730 Suspended aka: Olaca, Jules 00A228731 indefinitely effective13600 Marina Pointe 00A228732 10/18/01. Drive, #1207 00A228733Marina Del Rey, California 00A228734
00A22873500A228736
1 – Medi-Cal Suspended and Ineligible Provider ListSeptember 2007
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Physician ProviderNumber
Olmsted, Luke 00G583140 Suspended2538 C Street, Apt. 1 indefinitely effectiveSan Diego, California 4/26/95.
Olsen, Jeffrey D. 00G695710 Suspended4650 Barranca Parkway indefinitely effectiveIrvine, California 8/20/01.
Olson, Robert, III Suspended49 West Orange Grove indefinitely effectiveSierra Madre, California 5/4/95.
O’Neil, Kelly James A36888 Suspended40971 Winchester Road indefinitely effectiveTemecula, California 10/15/03.
Opsahl, Jon Steven G79640 Suspended930 South Mount Vernon indefinitely effective Avenue, Suite 400 5/1/02.Colton, California
Ordog, Gary Joseph G43038 Suspended23861 McBean Parkway, indefinitely effectiveSuite #D16 5/26/2006.Valencia, California
Ordoubadi, Nasser C50124 Suspended4613 Lake Washington indefinitely effective Boulevard SE 6/29/01.Bellevue, Washington
Ordonez-Sansusky, Lisa Y. A62384 Suspended477 Lassen Street, Apt. 3 indefinitely effectiveLos Altos, California 12/18/03.
Oremland, Fred D. 00C170040 Suspended16 Vista Drive indefinitely effectiveKentfield, California 10/1/96.
Organ, Paul Gerard A39998 Suspended3144 Broadway, indefinitely effectiveSuite #246 5/5/2006.Eureka, California and10850 MacArthur Boulevard,Suite #201Oakland, California
Ori, Vincent E. G41587 Suspended151 N. Sunrise Avenue, indefinitely effectiveSuite 611A 4/23/02.Roseville, California
Osman, M. Farouk 00C383250 Suspended aka: M. Farouk S. Osman indefinitely effectiveP.O. Box 11010 10/20/99.Indio, California
Physician ProviderNumber
Osova, Susan Lillian 74655 Suspended1081 N. China Lake indefinitely effective Boulevard 10/13/2006.Ridgecrest, California and310 Esplanade Avenue, #59Pacifica, California and3303 Harbor Boulevard, #D11Costa Mesa, California
Ouyang, Ruitson 00C398890 Suspended8641 Hillcrest Road indefinitely effectiveBuena Park, California 9/8/94.
Owens, Robert F. AFE28015 Suspended23273 Erwin Street indefinitely effectiveWoodland Hills, California 09/12/03.
Pacini, Luigi D. 00A232530 Suspended 301307 N. Commerce Street days effectiveStockton, California 1/10/92.
Page, Gary Wayne A67353 Suspended5688 South 1150 East indefinitely effectiveOgden, Utah 06/19/02.
Page, Phyllis E. GFE6611 Suspended2748 Coral Ridge Road indefinitely effectiveRancho Palos Verdes, California 07/16/03.
Paik, Phillip Chung Pil A50381 Suspended7750 Daggett Street, indefinitely effectiveSuite #108 12/8/2006.San Diego, California and3670 Wilshire Boulevard,Suite #505Los Angeles, California
Pak, Han Ho 00C388060 SuspendedP.O. Box 1403 indefinitely effectivePebble Beach, California 9/20/99.
Palmer, Landon L., M.D. 00C347310 Suspended1517 Storwell Center Plaza indefinitely effectiveSanta Maria, California 5/16/77. Psychiatric Medical ZZZ73144Z Group Central
Palmieri, Roger J. 00A299540 Suspended177 F. Riverside Avenue 00A299541 indefinitely effectiveNewport Beach, California 00A299542 11/4/94.
00A299543
1 – Medi-Cal Suspended and Ineligible Provider ListSeptember 2007
susp A44Physician Provider
Number
Panmai, Kraingsak 00C422930 Suspended3364 San Fernando Court indefinitely effectiveMerced, California 9/9/93.
Panner, Owen Murphy, Jr. G45866 SuspendedP.O. Box 1609 indefinitely effectiveAlturas, California 7/12/2005. and229 McDowell StreetAlturas, California
Panzer, Harold J. XPY020120 SuspendedZerox & Harrington indefinitely effectiveAinsworth, Nebraska 3/20/89.
Park, Jangwon 00A330590 Suspended12555 Garden Grove 00A330591 indefinitely effective Boulevard CGP048895 7/18/96.Garden Grove, California
Park, Jhong Dae 00C384790 Suspended440 N. Greenfield Avenue, #H indefinitely effectiveHanford, California 2/22/92.
Parker, Alexis Jane G52374 Suspended760 South Colorado indefinitely effective Boulevard, Suite #M 8/4/04.Denver, Colorado
Pasuhuk, Edwin H. 39666 Suspended29122 Amberwood Lane indefinitely effectiveHighland, California 6/23/2007. and895 W. Valley BoulevardColton, California
Patel, Rashmi Suspended19714 Arbor Ridge Drive indefinitely effectiveWalnut, California 6/5/97.
Patrick, Scott Benson A62379 Suspended8382 Dara Way indefinitely effectiveSacramento, California 4/20/99.
Patwell, Steven W. 00G582090 Suspended 605339 Elkhorn days effectiveSacramento, California 7/22/92.
Payne, Kenneth E. 00A210960 Suspended186 E. Rincon Avenue indefinitely effectiveCampbell, California 10/22/93.
Payne, Marc William 000E26160 Suspended2525 Villamonte Court indefinitely effectiveCamarillo, California 10/31/00.
Pearson, Keith M. 00A289400 SuspendedP.O. Box 86 indefinitely effective Cedar Glen, California 1/20/93.
Physician ProviderNumber
Peckler, John E. 00A153230 Suspended6069 North First Street, indefinitely effective#103 11/04/99.Fresno, California
Penaflorida, Rosalinda R. 00A316560 Suspended11137 Pierce Street indefinitely effectiveRiverside, California 12/19/91.
Pendleton, James Jr. G28670 Suspended5325 Broder Boulevard indefinitely effectiveDublin, California 8/18/2005.
Penn, Nathaniel Frederick G79855 Suspended300 East 300 S indefinitely effectiveMoab, Utah 04/28/04. and250 Hospital ParkwaySan Jose, California
Peoples, Robert William 00C348240 Suspended533 12th Street 00C348421 indefinitely effectiveManhattan Beach, California 5/20/99.
Perito, Paul Edward G82215 Suspended427 Biltmore Way indefinitely effectiveCoral Gables, Florida 05/28/04.
Perkins, Cassandra Paula 00C411100 Suspended aka: Cassandra 00C411101 indefinitely effective Van Nostrand 00C411103 6/18/98.2427 East Second Street 00C411104Los Angeles, California
Perrault, Mark D. A43550 Suspended6245 Bristol Parkway, indefinitely effectiveSuite #142 9/7/05.Culver City, California
Perry, Allan W., Sr. G4336 Suspended1808 Verdugo Boulevard, indefinitely effectiveSuite #118 12/10/2006.Glendale, California
Perzik, John David 00G145910 Suspended1059 Heatherfield Lane 00G145911 indefinitely effectiveSan Jose, California 00G145912 8/18/93.
Peters, Anthony N. A12130 Suspended901 South Glenoaks indefinitely effective Boulevard 09/17/04.Burbank, California
Peters, Katherine G67313 Suspended1811 East Grand Avenue, indefinitely effective#154 10/28/02.Escondido, California
1 – Medi-Cal Suspended and Ineligible Provider ListSeptember 2007
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Physician ProviderNumber
Peterson, Charles A. 00C290590 Suspended444 Estudillo Avenue indefinitely effectiveSan Leandro, California 2/20/00.
Peterson, Marion 00A138170 Suspended350 N. Fraser Drive, West indefinitely effectiveMesa, Arizona 2/13/96.
Petrie, Jonathan 00A265520 Suspended131 Red Hill Road indefinitely effectivePrinceton, New Jersey 8/23/94.
Petrusky, Robert M. 00G298730 Suspended3535 Lake Tahoe Road indefinitely effectiveS. Lake Tahoe, California 1/15/88.
Petty, Lisa R. 302396 Suspended aka: Lisa R. Wall indefinitely effective2319 Empress Avenue, Apt. 1 1/20/99.Sacramento, California
Pfaff, Charles Louis G31419 Suspended1300 North Pate Street, indefinitely effectiveH174 3/10/2005.Carlsbad, New Mexico and47111 Monroe StreetIndio, California
Pfister, Alene Maria G56772 Suspended615 Murray Lane indefinitely effectiveLafayette, California 08/25/04. and2200 Hayes StreetSan Francisco, California
Pfisterer, William H., M.D. 00G277640 Suspended 120400 N. Pomona days effectiveFullerton, California 4/19/91.
Phattiyakul, Pricha A37784 Suspended10331 Southern MD indefinitely effective Boulevard 09/19/01.Dunkirk, Maryland
Phillips, Donald K. 00A386180 Suspended3803 Union Avenue indefinitely effectiveBakersfield, California 10/23/94.
Phu, Khuong Minh, M.D. 00A224510 Suspended166 24th Street indefinitely effectiveRichmond, California 7/16/80.
Pickering, Bryant I. CFE20777 Suspended2531 East Vogel indefinitely effectivePhoenix, Arizona 03/13/00.
Physician ProviderNumber
Piedra, Arturo Gonzalez Unlicensed SuspendedCDC #V39124 indefinitely effectiveAvenal State Prison 7/20/05.P.O. Box 9Avenal, California
Pierre-Louis, Phillip Brian A42426 Suspended2322 College Avenue indefinitely effectiveSan Bernardino, California 05/27/03.
Pillemer, Eric Anthony G53145 Suspended3209 Vermont Route 30 indefinitely effectivePawlet, Vermont 11/14/02.
Pilovetzky, Pierre A52249 Suspended dba: Clinica Medica indefinitely effective Oxnard 4/10/2007.1739 Glenwood RoadGlendale, California and971 West 7th Street,Suite BOxnard, California and2151 West 6th StreetLos Angeles, California
Pineda, Anselmo A19894 Suspended2880 Atlantic Avenue, indefinitely effectiveSuite #160 1/11/05.Long Beach, California and6226 East Spring Street,Suite #380Long Beach, California
Pinhas, Simon 00G363340-42 Suspended1154 Tower Road indefinitely effectiveBeverly Hills, California 08/21/00.
Pinney, C. Tannert, Jr. 00G540220 Suspended5125 S.W. Baird Street indefinitely effectivePortland, Oregon 8/19/94.
Piper, Marvin A. G10907 Suspended2052 North Lake Avenue indefinitely effectiveAltadena, California 3/19/01.
Pirnia, Abdolvahab Steven 00C379620 Suspended29645 Rancho California Road indefinitely effectiveTemecula, California 08/18/00.
Pinnas, Jacob L. G17839 Suspended1601 North Tucson Boulevard, indefinitely effectiveSuite 32 12/03/02.Tucson, Arizona
1 – Medi-Cal Suspended and Ineligible Provider ListSeptember 2007
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Physician ProviderNumber
Pitman, Kathryn A. 00A402470 Suspended1027 Dorothy Drive indefinitely effectiveBrea, California 5/16/94.
Pitts, Ferris Newcomb WC36991A Suspended2810 East Del Mar indefinitely effective Boulevard, #4 2/19/98.Pasadena, California
Plourde, Steven Harold DC-16813 Suspended62504 Harrison Avenue, indefinitely effectiveSuite C 11/07/03.Eureka, California and2504-C Harrison AvenueEureka, California
Plunkett, Patrick 30729 Suspended300 W. Huntington Drive indefinitely effectiveArcadia, California 5/14/2007. and1231 Blair AvenueS. Pasadena, California and10 Congress Street, #202Pasadena, California
Po, Teofilo A23224 Suspended15929 Youngwood Drive indefinitely effectiveWhittier, California 7/19/02.
Pointer, Joseph, M.D. 000C64510 Suspended2919 MacDonald indefinitely effectiveRichmond, California 6/13/78.
Polin, Stanton G. G5784 Suspended4801 West Peterson Street, indefinitely effectiveSuite 406 03/13/00.Chicago, Illinois
Pollock, Lawrence 00G109080 Suspended9315 Telegraph Road 00G109081 indefinitely effectivePico Rivera, California 9/2/96.
Pollock, William Jack 31161 Suspended1313 East Herndon indefinitely effective Avenue, #105 6/21/2006.Fresno, California and1313 East Herndon Avenue, #101Fresno, California
Poncedeleon, Miguel 00A232400 SuspendedP.O. Box 282 00A232401 indefinitely effectiveDuarte, California 4/21/95.
Physician ProviderNumber
Ponrartana, Prasart A35226 SuspendedPonrartana Medical Clinic indefinitely effective3526 West First Street 3/28/01.Santa Ana, California
Portales, Ramon C40910 Suspended1336 Paseo Isabella indefinitely effectiveSan Dimas, California 7/1/02.
Powell, Perry 00C123660 Suspended aka: Perry O. Powell indefinitely effective Perry O. Powell, Jr. 2/19/98.2239 San Juan RoadSan Diego, California
Powell, Perry O. 00C123660 Suspended for 602330 1st Avenue days effectiveSan Diego, California 7/8/91.
Powell, Richard Wayne A46496 Suspended112 Linden Avenue indefinitely effectiveHagerstown, Maryland 8/6/03.
Power, William Randy G48668 Suspended10444 Santa Monica indefinitely effective Boulevard, #301 2/8/02.Los Angeles, California
Powers, Thomas R. A19276 Suspended1019 Brookside Avenue AFE19276 indefinitely effectiveRedlands, California 7/9/01.
Prabhakar, Ram A36231 Suspended57 Promenade indefinitely effectiveIrvine, California 3/1/2005. and4900 Barranca Parkway,Suite #104Orange, California and657 Camino De Los Mares,Suite #138San Clemente, California
Prastka, George, M.D. 00C253550 Suspended440 Fair Oaks Drive 00C253551 indefinitely effectiveCosta Mesa, California 1/9/81.
1 – Medi-Cal Suspended and Ineligible Provider ListSeptember 2007
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Physician ProviderNumber
Prendergast, Louis, M.D. 00C169190 Suspended5151 N. Palm Avenue 00C169191 indefinitely effectiveFresno, California 8/31/81.
Price, Howard M G54723 Suspended17 Smith Road indefinitely effectiveNorthborough, Massachusetts 8/24/04.
Price, Leonard A33665 Suspended2320 Bath Street indefinitely effectiveSanta Barbara, California 5/2/98.
Primero, Paterno Quita A34257 Suspended1808 Morning Dove Lane indefinitely effectiveRedlands, California 10/4/02.
Privitera, James, M.D. 00C304450 Suspended629 S. Eremland Drive indefinitely effectiveCovina, California 12/15/84.
Pugh, Condy M. 00G315370 Suspended100 S. San Mateo Drive indefinitely effectiveSan Mateo, California 12/2/87.
Purcell, Donald Joseph II G87313 SuspendedP.O. Box 3922 indefinitely effectiveNapa, California 6/20/05.
Purtell, Allison Elaine 00G486080 Suspended23881 Longspur Court indefinitely effectiveLaguna Niguel, California 04/03/00.
Purvis, Gene H. 00G291040 Suspended18118 Old Coach Road indefinitely effectivePoway, California 1/20/98.
Quarmby, Robert 00G567740 SuspendedP.O. Box 537 indefinitely effectiveWatertown, New York 06/16/00.
Quigley, Michael R. Suspended701 North Front Street, indefinitely effectiveApartment 412 11/20/03.Harrisburg, Pennsylvania
Physician ProviderNumber
Quintana, Elizabeth SuspendedSilverio Aleman 2217 indefinitely effectiveCL. Lopez Leyva 09/20/00.Tijuana, Baja California
Quintos, Rosario C. 00A378280 Suspended48 Park Plaza Drive, indefinitely effectiveNo. 317 3/21/97.Daly City, California
Quismoria, Antonio 00A308590 Suspended1108 Marin Street indefinitely effectiveVallejo, California 9/9/91.
Qurtom, Helmy A52829 Suspended Abdul-Fattah indefinitely effective4116 Howard Road 3/13/01.Beltsville, Maryland
Ramming, Kenneth Paul G27272 Suspended427 21st Street indefinitely effectiveSanta Monica, California 7/22/02.
Ramsden, Charles H. A17273 Suspended4310 Cahuenga Boulevard, indefinitely effective#104 4/5/01.Toluca Lake, California
Ramsey, James E. G20709 Suspended24411 Health Center indefinitely effective Drive, Suite 200 3/18/04.Laguna Hills, California
1 – Medi-Cal Suspended and Ineligible Provider ListSeptember 2007
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Physician ProviderNumber
Rana, Charu Mati 00C388230 Suspended667 Palm Avenue, Suite B 00C388231 indefinitely effective Imperial Beach, California 1/20/93.
Rand, David A. C29300 Suspended4232 East Cactus Road indefinitely effectivePhoenix, Arizona 02/05/03.
Rand, Phillip R. C11539 Suspended850 State Street, Suite #211 indefinitely effectiveSan Diego, California 5/18/2006.
Raneses, Jovencio 00C376870 Suspended11900 La Mirada 00C376871 indefinitely effective Boulevard 6/22/94.La Mirada, California
Ratanasen, Surahhan 00A347650 Suspended3042 Tulare Street 00A347651 indefinitely effectiveTulare, California 7/27/88.
Ratnam, Indran Suspended aka: Thurairatnam, indefinitely effective Indran Rajpal 01/05/89.325 Carolwood DriveHenderson, Nevada
Ravin, John Murrah G14582 SuspendedP.O. Box 3671 indefinitely effectiveTorrance, California 05/15/03.
Rayyis, Suad Salim A30760 Suspended610 North Central Avenue, indefinitely effectiveSuite 108 10/18/04.Glendale, California and1140 North Brand BoulevardGlendale, California and3001 West Berkeley Boulevard, Suite 101Montebello, California and13651 Vanowen StreetVan Nuys, California
Reddy, Mallam Hari A56371 Suspended Marayana indefinitely effective aka: Reddy, Hari 04/20/03. Marayana Reddy, Hari Narayana Ma9065 Sliver BoxVictorville, California and1505 West 17th StreetSan Bernardino, California
Physician ProviderNumber
Redmond, Geoffrey 00G756030 Suspended Plimsoll indefinitely effective23200 Chagrin Boulevard, 11/21/00.Bldg. 5, Suite 325Cleveland, Ohio
Rees, Joseph Richard G15150 Suspended5302 South 700 East indefinitely effectiveOgden, Utah 1/5/2006. and725 East 5350 South,Suite #120Ogden, Utah
Regester, Willard D. A15936 Suspended13792 Pierce Road indefinitely effectiveSaratoga, California 6/15/01.
Reich, Laurence Alan 20A4424 Suspended1875 Mandeville indefinitely effective Canyon Road 07/29/04.Los Angeles, California
Reichard, James W., M.D. 00A015399 Suspended800 Magnolia, #14 indefinitely effectiveCorona, California 9/10/90.
Reiman, John K. 00G108170 Suspended23190 Gold Springs Drive 00G108171 indefinitely effectiveColumbia, California 1/20/98.
Reisbord, David A. G8913 Suspended2080 Century Park East, indefinitely effective#203 10/19/2006.Los Angeles, California
Reiss, Jeffrey Ronald A36946 Suspended7220 Woodman Avenue, #106 indefinitely effectiveVan Nuys, California 4/15/99.
Reiswig, Oran K. 00A180430 Suspended95 Declaration Drive 00A180431 indefinitely effectiveChico, California 1/2/96.
Reiter, Alvin G24550 SuspendedP.O. Box 17877 indefinitely effectiveBeverly Hills, California 3/7/03.
Reitman, Toni Jean 00A369760 Suspended887 Lincoln Street indefinitely effectiveSan Luis Obispo, California 3/11/96.
Remer, Arnold E., M.D. 000G16200 Suspended236 A. S. First Avenue indefinitely effectiveArcadia, California 8/27/83.
1 – Medi-Cal Suspended and Ineligible Provider ListSeptember 2007
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Physician ProviderNumber
Renson, Jean F. 00A265530 Suspended2389 W. March Lane, Suite 5indefinitely effectiveStockton, California 11/7/95.
Resari, Lolita Quintal 00A334210-13 SuspendedCDC No: W85374 indefinitely effectiveCentral CA Women’s 06/09/00. FacilityP.O. Box 1508Chowchilla, California
ReVille, Donald N. 00A182930 SuspendedFederal Prisons Camp indefinitely effectiveP.O. Box 500 12/9/96.Boron, California
Reynaud, Raymond I., M.D. 00C171460 Suspended25 North 14th Street, #650 00C171461 indefinitely effectiveSan Jose, California 11/2/83.
Reynolds, Raymond G4823 Suspended4926 Hollywood Boulevard indefinitely effectiveLos Angeles, California 4/22/02.
Rha, Myung K. 00A332380 Suspended2005 Via Acalones 00A332381 indefinitely effectivePalos Verdes Estates, 5/17/94.California
Rhee, Ky Young 00C391540 Suspended130004 Maxwell Drive 00C391541 indefinitely effectiveTustin, California 00C391542 04/20/00.
00C391543
Richard, Robert M. A20450 Suspended522 Emerald Bay indefinitely effectiveLaguna Beach, California 06/27/03. and1355 San Pablo Street, Building 404Los Angeles, California
Rickabaugh, Donald E. A11257 Suspended307 Placentia Avenue, indefinitely effective#202 12/31/2004.Newport Beach, California
Rickard, Vernon D. G26114 Suspended19747 Greenley Road, indefinitely effectiveSuite 1 9/11/02.Sonora, California
Ridgill, Edward A. G40690 Suspended4130 Eadhill Place indefinitely effectiveWhittier, California 4/30/02.
Rifkind, Stephen Paul 00G386870 SuspendedP.O. Box 1448 indefinitely effectiveSanta Ynez, California 03/13/00.
Physician ProviderNumber
Riley, Anthony B. G62098 Suspended2816 Rudge Place indefinitely effectiveModesto, California 7/3/01.
Rist, James Kevin G60246 Suspended3527 Sacramento Street indefinitely effectiveSan Francisco, California 07/15/03. and450 Stanyan StreetSan Francisco, California
River, Elliot 00A208640 Suspended1800 31st Street indefinitely effectiveSan Francisco, California 12/1/96.
Rivera, John R A65911 Suspended aka: Rivera, Juan Indefinitely effective655 South Euclid Avenue, 06/30/04.Suite 409National City, California
Rivero, Evelyn C. A37002 SuspendedFountain Medical Clinic indefinitely effective4352 Fountain Avenue 06/04/03.Los Angeles, California
Roberts, Donald Lee 00G817390 Suspended aka: Donald A. Roberts XPY171790 indefinitely effective780 Camino de La Reina, 7/31/97.#254San Diego, California
Roberts, Edwin 00C143970 Suspended1320 Apple Avenue, indefinitely effectiveSuite 204 9/1/94.Hayward, California
Roberts, Lewis A. 00C112530 Suspended450 Sutter Street indefinitely effectiveSan Francisco, California 7/15/87.
Roberts, Theodore, M.D. 00G150390 Suspended9451 Grindlay Avenue indefinitely effectiveCypress, California 1/26/77. Civic Center Medical ZZZ70241Z Group, Inc.
Robertson, Charles A. 00G397270 Suspended325 Via Lido Nord indefinitely effectiveNewport Beach, California 4/20/95.
1 – Medi-Cal Suspended and Ineligible Provider ListSeptember 2007
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Physician ProviderNumber
Robertson, MacArthur M. 00G347250 Suspended3559 West Ramsey, 00G347251 indefinitely effectiveSuite D6 00G347252 4/4/97.Banning, California 00G347253
00G34725400G347255
Robinson, Kenneth Ellis G50240 Suspended4909 West Division, indefinitely effectiveSuite 307 08/11/00.Chicago, Illinois
Robinson, Malcolm George C32809 Suspended3900 North Harvey Parkway indefinitely effectiveOklahoma City, Oklahoma 08/08/02.
Robles, Carlos J., M.D. 00G312030 Suspended3801 Union Avenue ZZZ484127 indefinitely effectiveBakersfield, California 8/28/90.
Rock, Herman, M.D. 000G54600 Suspended795 Elm Street indefinitely effectiveSeaside, California 7/5/90.
Rock, Lewis Burnham, III 00C411080 Suspended1516 2nd Avenue, Suite 300 indefinitely effectiveSeattle, Washington 5/10/96.
Rodas, Jesus M. C15619 Suspended3004 Whittier Boulevard indefinitely effectiveLos Angeles, California 10/25/2006. and2026 East 1st StreetLos Angeles, California
Rodriguez, Antonio SuspendedCalle Endano 4809 indefinitely effectiveColonia Sanchez Tabomda 09/20/00.Tijuana, Baja California
Rohlfing, Walter A., III 00C336590 Suspended7125 Woodrow Drive indefinitely effectiveOakland, California 7/20/98.
Roller, Franklin D. 00C263500 Suspended2200 Fleerwood Drive 00C263501 indefinitely effectiveSan Bruno, California 12/12/88.
Physician ProviderNumber
Romero, Antonio Angeles A34298 Suspended9321 Florence Avenue indefinitely effectiveDowney, California 02/27/04. and9604 Artesia Boulevard, Suite 104Bellflower, California
Roop, Walter E. 00G247480 Suspended5644 Fulcher Avenue indefinitely effectiveN. Hollywood, California 4/10/95.
Rosas, Jose Antonio 72019 Suspended1580 Valencia Street indefinitely effectiveSan Francisco, California 6/11/2007. and973 Teresita BoulevardSan Francisco, California
Roschen, Fritz 00G177300 Suspended6900 Fall Way indefinitely effectiveElk Grove, California 9/5/94.
Rose, William W., Jr. 00A335570 Suspended2220 E. Anaheim Street indefinitely effectiveLong Beach, California 8/10/95.
Rosen, Baruch Daniel XPY037760 Suspended755 East Osborn, #206 indefinitely effectiveScottsdale, Arizona 12/2/96.
Rosenblatt, Michael M. 34153 Suspended11100 Warner Avenue, indefinitely effective#314 4/9/2007.Fountain Valley, California and1605 Haskell StreetBurlington, Iowa and321 8th Avenue WCresco, Iowa
Rosenstein, Melvyn 00G290050 Suspended dba: Rosenstein CGP046900 indefinitely effective Medical Group 7/29/96.3831 Hughes AvenueCulver City, California
Rosenthal, David K. A43832 Suspended2025 Morse Avenue indefinitely effectiveSacramento, California 6/28/01.
Rosenthal, George 00C295180 Suspended25441 Crescent Lane indefinitely effectiveLos Altos Hills, California 2/17/89.
Rosenthal, Michael J. G17628 Suspended1100 N. Oxford Avenue indefinitely effectiveClaremont, California 11/27/01.
Roth, Michael J. 00C344530 Suspended812 El Oro Lane indefinitely effectivePacific Palisades, California 8/20/98.
Rowell, George 00C397920 SuspendedRowell, Mildred indefinitely effective aka: George Pearson Rowell 12/19/97.24028 Lodge Pole RoadDiamond Bar, California
1 – Medi-Cal Suspended and Ineligible Provider ListOctober 2007
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Physician ProviderNumber
Rozenshtein, Frida A41476 Suspended aka: Rosenstein, Frida indefinitely effective11447 Dona Cecilia Drive 2/12/03.Studio City, California
Rudolph, Paul P. 00AX50790 Suspended11735 Norton Street indefinitely effectiveChino, California 1/5/97.
Rudominer, Arnold B. G55554 Suspended1591 Woodland Avenue indefinitely effectiveEast Palo Alto, California 5/20/98.
Rufo, Danny T. C33746 Suspended981 Leighton Way indefinitely effectiveSunnyvale, California 6/7/01.
Ruja, Richard G. G28684 Suspended1652 Greenwich Street indefinitely effectiveSan Francisco, California 05/15/03. and1356 Calistoga Avenue, #13Napa, California
Russell, Donald E. G58657 Suspended700 Hankins Drive indefinitely effectiveP.O. Box 1283 05/27/03.Fort Benton, Montana andP.O. Box 70Lake Arrowhead, California
Rutgard, Jeffrey 00G386030 SuspendedPrison No. 62908-198 00G386031 indefinitely effectiveFCI Fort Dix West 12/19/95.P.O. Box 3000Fort Dix, New Jersey
Rutland, Andrew G24947 Suspended7495 Hummingbird Circle SA18770 indefinitely effectiveAnaheim Hills, California 7/3/02.
Ryder, Robert 00A249680 Suspended23316 Ostronic Drive indefinitely effectiveWoodland Hills, California 4/14/95.
Physician ProviderNumber
Saber, Joseph Michael G31373 Suspended442 1900 Road indefinitely effectiveDelta, Colorado 03/27/03. and11234 Anderson StreetLoma Linda, California
Sabot, Theodore J., M.D. 000G88251 Suspended1149 Chestnut Street, #12 000G88250 indefinitely effectiveMenlo Park, California 4/26/85.
Sadeghi, Firooz C40713 Suspended126 South Jackson Street, indefinitely effectiveSuite #205 11/1/2004.Glendale, California and12440 Firestone Boulevard,Suite #101Norwalk, California and16520 Harbor Boulevard,Suite #AFountain Valley, California
Sadighian, Jim John A72734 Suspended1307 Janney Lane indefinitely effectiveAlexandria, Virginia 9/7/04.
Sagherian, Artin 00A363490 Suspended aka: Aritn S. Sagherian 00A363491 3/18/991660 Chevy Knoll Place 00A363492 for 5 years.Glendale, California 00A363493
00A36349400A36349500A363496
Sagmaquen, Rolanda 00A218850 Suspended2630 N. Locan 00A218851 indefinitely effectiveFresno, California 00A218852 2/22/95.
Saint-Erne, Philip Charles G50009 Suspended aka: St. John, Philip C. indefinitely effectiveP.O. Box 2171 4/21/03.Kenai, Alaska
Saks, Lawrence G36859 Suspended3445 Pacific Coast Highway, indefinitely effective#240 09/27/03.Torrance, California and701 East 28th Street, Suite 311Long Beach, California and1294 West 6th Street, #106San Pedro, California
1 – Medi-Cal Suspended and Ineligible Provider ListSeptember 2007
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Physician ProviderNumber
Salerno, Egisto A37903 Suspended5125 Jumilla Street indefinitely effectiveSan Diego, California 11/28/01.
Samadani, Sepehr G80848 Suspended811 4th Street, #A indefinitely effectiveSanta Monica, California 11/1/01.
Sambs, James M. 00G119600 SuspendedP.O. Box 90949 00G119601 indefinitely effectiveSan Diego, California 2/20/97.
Samuels, Arthur J. 00C131320 Suspended464 El Solyo Heights Drive indefinitely effectiveFelton, California 4/20/00.
Sanchez, Armando G. A44172 Suspended aka: Sanchez, Armando indefinitely effective900 Wayside Drive 9/20/04.Houston, Texas
Sanderger, Terry L. G39736 Suspended770 Magnolia Avenue, indefinitely effectiveSuite #2G 7/28/2006.Corona, California
Sanders, Edward C29998 SuspendedWayne, Jr. indefinitely effective5345 Martin Luther King 4/23/2007.Oakland, California and100 Ross RoadSausalito, California and2915 Telegraph AvenueBerkeley, California
Sanders, James H. XPY054060 SuspendedP.O. Box 880 indefinitely effectiveBarbourville, Kentucky 1/11/96.
Sanders, Marc, M.D. 00G200630 Suspended311 Shelton indefinitely effectiveMt. Shasta, California 11/7/83.
Sankary, Timothy M., M.D. 00G454710 Suspended445 Upper Terrace, #8 indefinitely effectiveSan Francisco, California 12/18/90.
Santos-Pizarro, Priscila 00A258070 Suspended aka: Priscila Rogue Santos indefinitely effective5231 Mt. Ariane Terrace 7/18/91.San Diego, California
Physician ProviderNumber
Sargeant, Thomas L. 00G604570 Suspended1140 Stags Leap Lane indefinitely effectiveAuburn, California 3/9/95.
Sarieva, Zoika G. 00A346950 Suspended3875 Wilshire Boulevard, 00A346950 indefinitely effectiveSuite 700 12/13/96.Los Angeles, California
Sarmiento, Maximo, M.D. 00A252760 Suspended1684 16th Avenue 00A252761 indefinitely effectiveSan Francisco, California 8/1/78.
Satloff, Lewis Marc G65170 Suspended c/o Aspinwall, Timothy J. indefinitely effective Esq. Nossman, Guthner, 12/21/01. Knox & Elliott915 L Street, Suite 1000Sacramento, California
Saucier, Billy PA11026 Suspended10357 Ruffner Avenue (Physician indefinitely effectiveGranada Hills, California Assistant) 10/15/99.
Saukerson, Stephen L. 00G153970 Suspended3289 Janes Road indefinitely effectiveArcata, California 5/14/86.
Saunders, Francis Leon 00G210180 Suspended1419 Rimrock indefinitely effectiveChico, California 01/25/00.
Sayyah, Masood R. A42949 Suspended713 Euclid Street indefinitely effectiveSanta Monica, California 12/13/2005. and115 East Washington BoulevardLos Angeles, California and 281 Columbia AvenueLos Angeles, California
Scallion, Gerald J. C43281 Suspended81-893 Dr. Carreon Boulevard, indefinitely effectiveSuite 5 11/5/02.Indio, California
Schade, Hugh 00A202970 Suspended1217 Melba Court 00A202971 indefinitely effectiveSan Jose, California 12/9/96.
Scheetz, David C25982 SuspendedP.O. Box 2349 indefinitely effectiveSanta Rosa, California 10/08/02.
Scheibner, Adrianna A48204 Suspended435 N. Bedford Avenue, indefinitely effective Suite 104 6/18/98.Beverly Hills, California
1 – Medi-Cal Suspended and Ineligible Provider ListSeptember 2007
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Physician ProviderNumber
Schein, Herbert, M.D. Suspended6009 Seaside Walk, Apt. #3 indefinitely effectiveLong Beach, California 5/30/91.
Schick, Peter Michael G19695 Suspended15243 Vanowen Street, indefinitely effectiveSuite 210 11/01/02.Van Nuys, California
Schickner, David John G65201 Suspended3115 Pine, Suite 905 indefinitely effectiveWaco, Texas 08/14/03.
Schiff, Harold Bernard A39225 Suspended446 Brookline Street indefinitely effectiveNewton Centre, Massachusetts 08/18/03.
Schlater, Theodore L., III Suspended5041 Angeles Vista indefinitely effectiveLos Angeles, California 12/9/96.
Schlom, Louis 00A286140 Suspended1445 Skyline Drive indefinitely effectiveLemon Grove, California 5/2/92.
Schmidt, Clarence 00A106450 Suspended306 N. Conyer Street, #3 indefinitely effectiveVisalia, California 11/15/91.
Schmitz, Robert E. C17149 SuspendedP.O. Box 3385 indefinitely effectivePalm Springs, California 6/24/02.
Schmerler, Elliot Dean A41143 Suspended9436 Double R Boulevard indefinitely effectiveReno, Nevada 10/03/03. and774 Mays BoulevardIncline Village, Nevada
Schneider, Eduardo 00A429800 Suspended15743 Amar Road indefinitely effectiveLa Puenta, California 3/17/95.
Schneider, Norman B., M.D. 00G233910 Temporarily211 S. Montclair Street suspended effectiveBakersfield, California 11/20/84.
Schoen, Joya Lynn, M.D. 00G141300 Suspended157 East New England 00G141301 indefinitely effectiveWinter Park, Florida 10/21/75.
Schourup, Julie 00072546 Suspended7055 North Pueblo Place indefinitely effectiveMcNeal, Arizon 10/19/00.
Schroeder, Vernon 00A285080 Suspended80-000 Ave., 49 N. Cactus, 00A285081 indefinitely effective#294 1/17/97.Indio, California
Physician ProviderNumber
Schuler, James D. 00G000560 Suspended19755 Balfour Drive indefinitely effectiveP.O. Box 427 10/8/92.Strathmore, California
Schuler, James D. 0000G5670 Suspended12559 Hwy. 101 North indefinitely effectiveP.O. Box 297 10/8/92.Smith River, California
Schuler, Willard Donald G28700 Suspended9141 Grant Street, Suite 240 indefinitely effectiveThornton, Colorado 1/1/01.
Schusselin, Omar, M.D. 00A399220 Suspended626 S. 2nd Avenue indefinitely effectiveCovina, California 2/10/85.
Schwartz, Francis X. A50748 Suspended aka: Schwartz, Francis indefinitely effective Xavier, Jr. 2/20/02.1525 Lakeside Drive, #9Oakland, California
Schwartz, Stanley Joel Physician SuspendedP.O. Box 5449 Assistant indefinitely effectiveRichmond, California 7/11/95.
Scontas, George J. 00A349880 Suspended1100 Hardee Road, Suite 103 indefinitely effectiveKinston, North Carolina 2/9/96.
Scoon, Malcolm E. G78562 SuspendedDIN #99A4397 188022 indefinitely effectiveBare Hill Correctional 12/17/98. FacilityCaller Box 20, Cady RoadMalone, New York
Scott, Barbara J. Suspended8001 Jellico Avenue indefinitely effectiveNorthridge, California 12/9/96.
Scott, James L., Jr. 00C217060 Suspended11649 County Club Lane 00C217061 indefinitely effectiveDenver, Colorado 8/18/93.
Scott, Stephan Allan G61226 Suspended3860 Saddle Road indefinitely effectiveSouth Lake Tahoe, California 10/28/2004.
Scott, Terry Wesley 00G545360-62 Suspended1111 South Grand Avenue, 03/15/00Suite E for 3 years.Diamond Bar, California
Scotti, Stephen D. G87593 Suspended164 Commonwealth Avenue indefinitely effectiveSpringfield, Vermont 10/18/01.
1 – Medi-Cal Suspended and Ineligible Provider ListSeptember 2007
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Number
Scotton, Thomas F. 00C389070 SuspendedP.O. Box 91207 00C389071 indefinitely effectivePasadena, California 2/18/99.
Scull, Alvis J., Jr., M.D. 00C131840 Suspended724 Mission Canyon Road indefinitely effectiveSanta Barbara, California 8/28/90.
Seard, Charles Henry 00G109750-52 SuspendedP.O. Box 3731 indefinitely effectiveStockton, California 02/29/00
Segal, Gordon 00G413930 Suspended18552 MacArthur Boulevard indefinitely effectiveNewport Beach, California 11/6/91.
Sela, Michael M., M.D. 00A389860 Suspended960 East Green Street, #207 indefinitely effectivePasadena, California 8/8/95.
Sellers, Anthony Bruce G80081 Suspended1371 West Cerritos Avenue, indefinitely effectiveNo. 83 08/01/02.Anaheim, California
Seyoum, Mesfin, M.D. 00G042634 Suspended330 E. Kelso Street indefinitely effectiveInglewood, California 10/11/90.
Shaffer, Jay Hammond C36420 Suspended3113 Morning Way indefinitely effectiveLa Jolla, California 10/06/03. and7946 Ivanhoe Avenue, Suite 310La Jolla, California and225 Dickinson StreetSan Diego, California
Shah, Mukesh H. 00A449502 Suspended10760 Andy Street indefinitely effectiveCerritos, California 5/4/94.
Shah, Mukesh H. A44952 Suspended1309 Robert Court indefinitely effectiveBrea, California 06/21/00. and3403 West Beverly BoulevardMontebello, California
Shahid, Syed Iqbal Hussain 00A299970 SuspendedP.O. Box 1596 00A299971 indefinitely effectiveLomita, California 1/27/99.
Shaiken, Eugene 00G197590 Suspended2180 Johnson Avenue indefinitely effectiveSan Luis Obispo, California 2/18/94.
Shallenberger, Frank 00G272540 Suspended1524 Highway 395 indefinitely effectiveGardnerville, Nevada 4/7/95.
Physician ProviderNumber
Sharma, Kanu 00A408540 Suspended14673 Parthenia indefinitely effectivePanorama City, California 4/25/87.
Sharma, Manorama A37350 Suspended16989 Edgewater Lane indefinitely effectiveHuntington Beach, 5/20/2007.California
Shaw, Michael G. Suspended8721 2nd Avenue indefinitely effectiveInglewood, California 12/9/96.
Shaw, Richard K. 000G66210 Suspended3480 Harbor Drive 000G66211 indefinitely effectiveAtwater, California 7/21/95.
Shearer, Lawrence G37221 Suspended Richard indefinitely effective aka: Shearer, Richard L. 07/21/04.701 Pine StreetMount Shasta, California and534 North Main StreetYreka, California and830 Pine Street Mount Shasta, California
Sheen, Jack Henry A16577 Suspended26 Sea View Drive indefinitely effectiveMontecito, California 02/04/04. and9201 Sunset Boulevard, #814Los Angeles, California and9201 W. Sunset Boulevard, Suite 8Los Angeles, California
Sheffer, Lee A. C31421 SuspendedP.O. Box 5187 indefinitely effectiveOroville, California 5/29/02.
Shen, Anthony C. 00G225230 Suspended13800 Arizona Street indefinitely effectiveWestminster, California 7/24/87.
Sheppard, Stephen 00A275220 Suspended3737 Moraga Avenue, #A5 00A275221 indefinitely effectiveSan Diego, California 5/20/92.
Shere, Johsua 00G150090 Suspended11011 Ophir Drive indefinitely effectiveLos Angeles, California 04/20/00.
Sherman, Michael A40995 Suspended3268 La Crecenta Avenue indefinitely effectiveGlendale, California 10/01/03.
1 – Medi-Cal Suspended and Ineligible Provider ListSeptember 2007
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Physician ProviderNumber
Sherwood, Harold R. 000C80950 Suspended9931 Venice Boulevard indefinitely effectiveLos Angeles, California 5/17/94.
Sheth, Alka 00A356890 Suspended2023 W. Vista Way indefinitely effective Vista, California 11/5/91.
Shetty, Nagesh 00A334950-51 SuspendedP.O. Box 3106 indefinitely effectiveCosta Mesa, California 06/19/00.
Shih, Hsien Shou A41812 Suspended aka: Shih, Michael indefinitely effective Shou, Hsien 2/26/01.517 Gloria RoadArcadia, California
Shimotsu, Grace Ellen A52762 Suspendedc/o Samuel Simmonds indefinitely effective Memorial Hospital, Box 29 8/28/02.Barrow, Alaska
Shoelah, Hossien M. Suspended2855 Pine Creek Drive indefinitely effectiveCosta Mesa, California 12/9/96.
Shohayeb, Ahmed 00A388950 Suspended Abdul Rahma 00A388951 indefinitely effective1704 S. Robertson Boulevard 2/20/98.Los Angeles, California
Shultz, Richard Raymond 00G102400 Suspended13847 E. 14th Street, indefinitely effective Suite 208 5/20/98.San Leandro, California
Shumaker, Scott Suspended1838 N. 2550 East indefinitely effectiveLayton, Utah 12/20/98.
Siddall, Donley Dee G22493 SuspendedBox 553 indefinitely effectiveCollegedale, Tennessee 01/06/04.
Siegel, Howard M. G57480 Suspended419 Main Street indefinitely effectiveHuntington Beach, California 06/16/03.
Siegel, Philip 00G144290 SuspendedP.O. Box 630465 CG0043740 indefinitely effectiveMiami, Florida S25219 09/20/00.
(FL) ME28703
Sieja, Theodore Woodrow 00G361440 Suspended1036 Van Dyke Drive indefinitely effectiveLaguna Beach, California 3/28/01.
Siering, William 00A286590 Suspended 901400 Florida, Suite 207 days effectiveModesto, California 4/12/92.
Physician ProviderNumber
Siggers, Richard L., M.D. 000G16590 Suspended 15065 Alondra Boulevard indefinitely effectiveLa Mirada, California 2/18/94.
Silva, Enriqueta 00A362750 Suspended2033 West Seventh indefinitely effective Street, #8 4/13/95.Los Angeles, California
Simanonok, John P. Suspended141 Robert E. Lee, #326 indefinitely effectiveNew Orleans, Louisiana 11/9/94.
Simay, Douglas A. G34521 Suspended210 Coast Boulevard indefinitely effectiveLa Jolla, California 01/21/04.
Simmons, Earl Melvin G43704 Suspended267 North El Camino Real, indefinitely effectiveSuite I 10/18/02.Encinitas, California
Simon, Joseph H. G15317 Suspended3447 Lake Tahoe indefinitely effective Boulevard, #2 01/09/04.South Lake Tahoe, California
Simon, Roy H. G60934 Suspended3445 Pacific Coast Highway, indefinitely effectiveSuite 300 1/4/02.Torrance, California
Singer, Michael D. 00G575540 Suspended3929 Spur Hill indefinitely effectiveBloomfield, Michigan 2/15/94.
Singhal, Anil M. 00G654060 Suspended4043 Hastings Park indefinitely effectiveSan Jose, California 3/26/97.
Sircar, Samar A31260 SuspendedP.O. Box 10036 indefinitely effectiveTorrance, California 8/27/02.
Sison, Renato Fernandez A48516 Suspended3714 Tibbetts Street, #104 indefinitely effectiveRiverside, California 1/8/03.
Slocum, Wesly G., M.D. 00C237330 Suspended6151 Mission Boulevard indefinitely effectiveRubidoux, California 11/1/76.
1 – Medi-Cal Suspended and Ineligible Provider ListSeptember 2007
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Number
Smars, Gunnar Anders 00G439850 Suspended aka: Daniel Gould indefinitely effective2094 West Redlands 03/31/00. Boulevard, Suite K168Redlands, California
Smialowicz, Ronald G34157 Suspended Kenneth indefinitely effective909 Hyde Street, 8/01/2006.Suite #115San Francisco, California
Smith, Charlie Frank, Jr. 00C370180 Suspended696 Oak Grove Road 10/20/99Gray, Tennessee for 20 years.
Smith, Christopher Tremel A64009 Suspended899 Grove Street indefinitely effectiveSan Francisco, California 07/20/00.
Smith, Gerald F. 00G169830 Suspended1000 S. Anaheim Boulevard 00G169831 indefinitely effectiveAnaheim, California 00G169832 7/26/88.
Smith, James J., M.D. 00A291420 Suspended24760 Sunnymead indefinitely effective Boulevard, #105 3/21/87.Sunnymead, California
Smith, Jeffry A. C40820 Suspended aka: Smith, Jeffrey Alan indefinitely effective231 E. Alessandro Boulevard, 3/5/02.#A315Riverside, California
Smith, Sidney Dion C32250 Suspended347 Noe Street indefinitely effectiveSan Francisco, California 10/13/2005. and660 Sanitarium Road, #302Deer Park, California
Smith, William F., Jr. 00C182510 Suspended531A West Grand Avenue 00C182511 indefinitely effectiveOakland, California 00C182512 4/13/94.
Smith-Vaniz, Allison G85379 Suspended322 Bird Rock Avenue indefinitely effectiveLa Jolla, California 01/12/00.
Physician ProviderNumber
Smoler, Barry 00G232990 Suspended2885 Nicada Drive indefinitely effectiveLos Angeles, California 7/18/96.
Smolin, Alvin B., M.D. 00C188270 Suspended2007 Wilshire Boulevard GR0012150 indefinitely effectiveLos Angeles, California GR0019100 10/31/85.
Snyder, Lawrence K. CGP147385 Suspended2812 Regent Street 00G173190 indefinitely effectiveBerkeley, California 00G173191 8/20/98.
00G173192
Sobolev, Galina A40087 Suspended aka: Gruzan-Sobolev, Galina indefinitely effective2303 Weybridge Lane 11/19/02.Los Angeles, California
Sohl, Frederick 00A199070 Suspended630 Mission Street indefinitely effectiveSouth Pasadena, California 8/22/95.
Sokolski, Kenneth Neil 00G645980 Suspended5 Gibbs Court indefinitely effectiveIrvine, California 5/31/97.
Solana, Louis J. 00A285290 Suspended1902 Royalty Drive, #260-A indefinitely effectivePomona, California 1/5/92.
Somogyi, Emil L. 00A199410 Suspended1059 Via Alta 00A199411 indefinitely effectiveLafayette, California 10/7/98.
Songdej, Nitivadee 00A480110 Suspended18635 Klum Place indefinitely effectiveRowland Heights, California 4/18/96.
Sonntag, Robert W. 00A194600 Suspended7080 Hollywood Boulevard indefinitely effectiveHollywood, California 6/8/88.
1 – Medi-Cal Suspended and Ineligible Provider ListSeptember 2007
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Physician ProviderNumber
Sossong, Norman, M.D. 00G399360 Suspended 905150 E. Hill Road, #E days effectiveLakeport, California 3/18/91.
Soundaranajan, A-26101 SuspendedThalavaipalayam indefinitely effective aka: Rajan, T.S.S. 12/13/2004.539 Telegraph Canyon Road,Suite #438Chula Vista, California
Southwood, Eric 00A170870 Suspended722 Palomar Drive indefinitely effectiveRedwood City, California 7/21/95.
Sowers, James A. 00G11590 Suspended1171 West Shaw, #101 00G11591 indefinitely effectiveFresno, California 7/5/95.
Spangher, Guido G. G44865 SuspendedP.O. Box 265 indefinitely effectiveFort Meade, South Dakota 12/18/00.
Speier, Susana Alicia A53714 Suspended16 Via Terrano indefinitely effectiveRancho Margarita, 8/20/2006.California
Spertell, Robert B., M.D. 00G372890 Suspended801 Brewster Avenue, #240 GR0028920 indefinitely effectiveRedwood City, California 9/25/90.
Spinello, Guy V. 000G68250 Suspended3801 S. Vermont Avenue indefinitely effectiveLos Angeles, California 7/31/87.
Spitzer, Henry, M.D. 00C103060 Suspended314 Monterey Road indefinitely effectivePalm Springs, California 5/15/90.
Sprague, Margaret M., G56228 SuspendedM.D. indefinitely effective2706 Azul Street 11/20/2006.La Jolla, California and3252 Holiday Court,Suite #100La Jolla, California
Physician ProviderNumber
Springer, Clyde H. 00C397300 SuspendedAberfoyle Medical Arts Bldg. 00C397301 indefinitely effectiveBlack Rock Road 00C397302 8/2/93.St. Michael, Barbados, W.I.
Springer, James 00C182070 Suspended49155 3 PTS Road indefinitely effectiveLancaster, California 4/21/94.
Srinarayana, Hanumaiah A37753 Suspended2001 Avenue F, Suite 38 13138 (AZ) indefinitely effectiveEl Campo, Texas 3/27/01.
Srivastava, Krishna 00A364660 Suspended11008 Wilson Avenue 00A364661 indefinitely effectiveAlta Loma, California 00A364662 5/6/96.
Stakely, James L. A22632 Suspended111 Elm Street, Suite 101 indefinitely effectiveSan Diego, California 07/15/04. and9554 La Jolla Farms RoadLa Jolla, California
Stanton Jr., Francis X. G53287 Suspended1327 Caminito Batea indefinitely effectiveLa Jolla, California 12/21/00.
Stebbins, Robert D. 00G180670 Suspended770 Welch Road, Suite 300 CGP071220 indefinitely effectivePalo Alto, California 7/20/98.
Steel, Samuel L. A56274 Suspended10956 Babe Ruth Street indefinitely effectiveEl Paso, Texas 08/14/03.
Steen, Bernard R. 00G272300 Suspended6183 N. Fresno Street, indefinitely effectiveSuite 101 1/25/93.Fresno, California
Steinberg, Harry 00A280270 Suspended1633 E. Fourth Street, #140 indefinitely effectiveSanta Ana, California 9/23/92.
Steinberg, Harry 00A280271 Suspended16636 Crenshaw Boulevard indefinitely effectiveTorrance, California 9/23/92.
1 – Medi-Cal Suspended and Ineligible Provider ListSeptember 2007
susp A58Physician Provider
Number
Steir, Bruce 00C244660 Suspended1226 Masonic 00C244661 indefinitely effectiveSan Francisco, California 3/18/97.
Steller, Robert T. G16986 Suspended11953 Rochester indefinitely effective Avenue, #8 05/09/03.Los Angeles, California or3200 Santa Monica BoulevardSanta Monica, California
Stepak, Paul Howard, M.D. G50113 Suspended4736 California Street indefinitely effectiveSan Francisco, California 5/3/89.
Stepan, Daniel Edward G60533 Suspended158 Western Avenue indefinitely effectiveMorristown, New Jersey 08/18/04. and1500 Duarte RoadDuarte, California
Sterns, Jordan B. Suspended55755 Baltimore Road, #105-154 indefinitely effectiveLa Mesa, California 9/20/99.
Stevens, James Blaine G64859 Suspended dba: Pinnacle Anesthesia indefinitely effective Consultants 12/7/01.13601 Preston Road, Suite 900 WDallas, Texas
Stevens, Mark T., M.D. 00G653600 Suspended860 Jamacha Road, #106 indefinitely effectiveEl Cajon, California 8/30/91.
Stevenson, Melbourne, M.D. 00A279120 Suspended934 Second Street 00A279121 indefinitely effectiveSanta Monica, California 00A279122 7/12/84.
Stiers, William Jefford G42398 Suspended3805 Mohr Avenue indefinitely effectiveAlameda, California 4/03/2006. and9300 Valley Childrens PlaceMadera, California and5555 West Las Positas BoulevardPleasanton, California and1111 East Stanley BoulevardLivermore, California
Physician ProviderNumber
Strahan, Ronald Wayne C28592 Suspended289 Tigertail Road indefinitely effectiveLos Angeles, California 03/31/00. and11645 Wilshire Boulevard,Suite 1150Los Angeles, California
Strate, Gerald H. 00C155640 Suspended216 West Perkins, indefinitely effective #317, Suite 104 2/15/94.Ukiah, California
Strawn, Dale A., M.D. 00A113160 Suspended39 42nd Avenue indefinitely effectiveVancouver BC, Canada 10/17/91.
Streib, Homer F. 00C121210 Suspended aka: Frederick Streib indefinitely effective3698 Valley Vista Road 7/20/99.Bonita, California
Streifel, John Author PV0066140 Suspended1298 Coe Street indefinitely effectiveCamarillo, California 4/20/99.
Strub, Daniel A25554 Suspended aka: Strub, Danny indefinitely effective12620 Monte Vista Road, #E 07/23/03.Poway, California
Sturckow, Karl H. C22009 Suspended9817 Main Avenue indefinitely effectiveLakeside, California 1/25/02.
Suffin, Gustane, M.D. 00A280760 Suspended21418 S. Norwalk 020A19870 indefinitely effective Boulevard 8/2/86.Hawaiian Gardens, California
Sugarbaker, Stephen Philip G62971 Suspended503 East High Street indefinitely effectiveJefferson City, Missouri 07/06/00.
Sullivan, Francis J. 00C255100 Suspended12-076 Palm Drive indefinitely effectiveDesert Hot Springs, California 12/26/87.
Sullivan, Kevin Paul 00G357650 Suspended aka: Kevin P. Sullivan indefinitely effective4441 S. Mendion 4/20/99.Puyallup, Washington
1 – Medi-Cal Suspended and Ineligible Provider ListSeptember 2007
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Physician ProviderNumber
Sutterfield, Thomas C. 00G126700 Suspended71-255 El Paseo, Suite 8 indefinitely effectivePalm Desert, California 5/28/01.
Sutton, Clarence Jr. G74582 Suspended101 North La Brea, indefinitely effectiveSuite 306 11/12/03.Inglewood, California and3132 Van Nostran DriveLakewood, California and1859 North Vineyard Avenue, Suite BOntario, California
Suzuki, Anthony 00G694010 Suspended5881 Adderley Drive indefinitely effectiveLong Beach, California 09/03/99.
Sviokla, Sylvester Charles 00G254290-01 Suspended8238 Paseo Del Ocaso indefinitely effectiveLa Jolla, California 2/20/00.
Swanson, Karl G60534 Suspended1651 Florence Avenue indefinitely effectiveFort Walton, Florida 11/15/00.
Sweet, Brian R. 00C420220 Suspended20440 Highway 18 indefinitely effectiveApple Valley, California 4/27/95.
Swerdloff, Fred 00G446540 Suspended8631 W. 3rd Street, indefinitely effectiveSuite 840E 2/14/95.Los Angeles, California
Sy, Evancia 00A459940-42 SuspendedCDC # W84860 indefinitely effectiveCentral CA Women’s Facility 05/08/00.P.O. Box 1501Chowchilla, California
Physician ProviderNumber
Syal, Parvin D. 00A377540 Suspended19486 Kilfinan Street 00A377541 4/20/99Northridge, California 00A377542 for 15 years.
00A37754300A37754400A37754500A37754600A377547
Szeilbert, Leslie A. 00A427210 Suspended1460 North 16th Avenue, indefinitely effectiveSuite G 08/14/00.Yakima, Washington
Tahan, Victor G. 000G27940 Suspended9400 E. Amistad Street indefinitely effectivePlanada, California 11/30/96.
Takasugi, Scott T. A43093 Suspended2025 Morse Avenue indefinitely effectiveSacramento, California 6/21/2006.
Takeuchi, Ernest Isamu 00G275770 Suspended316 Blue Rock Drive indefinitely effectiveAntioch, California 01/28/00.
Talisman, Mark Z. 00A243150 Suspended7718 Appaloosa Trail 00A243151 indefinitely effectiveOrange, California 2/5/93.
Tapia, Eugene, M.D. 00C391560 Suspended613 N. Haney indefinitely effectiveReedley, California 8/27/86.
Tartaro, Thomas 00G416880 Suspended1596 S. Imperial Avenue 00G416881 indefinitely effectiveEl Centro, California 5/5/95.
Tatreau, Robert, M.D. 00C382520 Suspended1318 Johnson Avenue indefinitely effectiveSan Luis Obispo, California 10/22/91.
Tehrani, Abolghasem M. A38064 Suspended11260 Chalon Road indefinitely effectiveLos Angeles, California 3/2/2007. andP.O. Box 491450Los Angeles, California andP.O. Box 20040Encino, California and222 W. Eulalia, #200HGlendale, California
1 – Medi-Cal Suspended and Ineligible Provider ListSeptember 2007
susp A60
Physician ProviderNumber
Tennant, Forest S. G22141 Suspended dba: Community Health Project indefinitely effective1744 Aspen Village Way 10/1/00.West Covina, California
Theofrastous, James 00G646860 SuspendedUCSD Medical Center indefinitely effectiveDepartment of Reproductive 2/21/96. MedicineSan Diego, California
Thill, Albert 00A134880 Suspended10675 Orange Park indefinitely effectiveOrange, California 10/31/89.
Thomas, Claude R. 00A202040 Suspended124 E. Webster indefinitely effectiveColusa, California 5/19/89.
Thomas, Richard W. A17585 Suspended1730 Huntington Drive, indefinitely effectiveSuite 202 3/7/02.South Pasadena, California
Thompkins, Bennie Lee 00C422350 Suspended18th Avenue & Hwy 53 indefinitely effectiveClearlake, California 6/5/92.
Thompson, Steven Howard A64652 Suspended3006 Bayside Drive indefinitely effectiveRockwall, Texas 03/05/03. and 4647 Zion AvenueSan Diego, California
Thorngate, David 000G27250 Suspended929 Pacific Street indefinitely effectiveMonterey, California 05/08/00.
Physician ProviderNumber
Thorngate, Stephen M. 000G38590 SuspendedWest 4957 Aspen indefinitely effectivePark Falls, Wisconsin 10/10/95.
Thorp, Richard Hardy G14937 Suspended6151 North Fresno, Suite 101 indefinitely effectiveFresno, California 03/05/03.
Thoshinsky, Morton J. A15478 Suspended101 Lombard Street, #206W indefinitely effectiveSan Francisco, California 11/21/02.
Thurtle, Robert J. 00C237470 Suspended584 Castro indefinitely effectiveSan Francisco, California 7/15/89.
Tibbles, Jay Harold 00G354670 Suspended9985 Sierra Avenue indefinitely effectiveFontana, California 04/08/02. andLoma Linda University Medical CenterLoma Linda, California and9961 Sierra AvenueFontana, California
Tilby, Brian B. 00C297790 SuspendedFresno & R Streets indefinitely effectiveFresno, California 5/18/87.
Tillim, Stephen Leonard G25344 Suspended2204 Grant Road, indefinitely effectiveSuite 203 06/03/03.Mountain View, California and2660 Solace Place, Suite, BMountain View, California and525 South Drive, Suite 213Mountain View, California
1 – Medi-Cal Suspended and Ineligible Provider ListOctober 2007
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Physician ProviderNumber
Tison, Dennis Jay G79603 Suspended87 Scripps Drive, Suite 308 indefinitely effectiveSacramento, California 7/10/02.
Todd, Kenneth D. G46340 Suspended7932-C Wrenwood Boulevard indefinitely effectiveBaton Rouge, Louisiana 6/10/02.
Toma, Paul 00C116570 Suspended16425 Wood Valley Trail 00C116571 indefinitely effectiveJamul, California 2/13/97.
Toot, Byron V. 00C416350 Suspended3 Long Pine indefinitely effectiveIrvine, California 12/18/97.
Torreblanca, Jose Manuel A41327 Suspended dba: San Martin De indefinitely effective Porres Medical Clinic 11/19/02.10001 California AvenueSouth Gate, California
Torres, Carla 00A414380 Suspended642 Dolores Avenue indefinitely effectiveSan Leandro, California 7/18/96.
Torrey, Robert R. A12153 Suspended514 Continental Court indefinitely effectivePasadena, California 3/6/2006. and5417 York BoulevardLos Angeles, California and1530 East Chevy Chase Drive, #20Glendale, California and1620 West Avenue JLancaster, California
Towles, William J. 000G56370 Suspended106 Pine Wood Lane indefinitely effectiveLos Gatos, California 4/18/96.
Trabulus, Norman 000G29090 Suspended13661 Chandler Boulevard 000G29091 indefinitely effectiveVan Nuys, California 12/5/00.
Trahms, Robert George 00C248150 Suspended1 Heathcliff Drive indefinitely effectiveTiburon, California 2/24/98.
Physician ProviderNumber
Trang, Si D., M.D. 00A393670 Suspended150 W. Valley Boulevard indefinitely effectiveSan Gabriel, California 2/15/86.
Tretbar, Lawrence G13137 Suspended8787 Ballentine, Suite #1200 indefinitely effectiveShawnee Mission, Kansas 6/22/04.
Trindle, Michael R. G63287 Suspended611 Laurel Avenue indefinitely effectiveMillbrae, California 04/04/04. and505 Parnassus AvenueSan Francisco, California
Trujillo, Martin, M.D. 00G326740 Suspended 602416 Castillo Street, #B days effectiveSanta Barbara, California 4/10/91.
Trujillo, Martin, M.D. 00G326741 Suspended 602520 Financial Square, #21 days effectiveOxnard, California 4/10/91.
Trunnell, Thomas L., M.D. 000G99210 Suspended8001 Frost Street indefinitely effectiveSan Diego, California 6/22/90.
Trusnovic, William Daniel G70311 Suspended173 Malone Ridge Road indefinitely effectiveWashington, Pennsylvania 08/13/03. and1401 Garces HighwayDelano, California
Tsai, David Chang-Chur 00A309490 Suspended3717 Novel Drive, #1215 indefinitely effectiveSan Diego, California 11/18/99.
Tsui, Yat Kwon, M.D. 00A394400 Suspended7783 Sleepy River Way indefinitely effectiveSacramento, California 5/15/91.
Tucker, Eric Clinton A21469 Suspended1586 Old House Road indefinitely effectivePasadena, California 8/14/91.
Tucker, James Edward 00G356230 Suspended1648 8th Street indefinitely effectiveManhattan Beach, California 9/18/00.
Tulumello, Joseph G24200 Suspended Santo, M.D. indefinitely effective3880 Lockport Olcott Road, Lot 25 02/03/03.Lockport, New York or17450 Main Street, Suite IHesperia, California or18031 US Highway 18, Suite AApple Valley, California
1 – Medi-Cal Suspended and Ineligible Provider ListSeptember 2007
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Physician ProviderNumber
Turner, Charles W., M.D. 00C150970 Suspended1905 N. College Avenue indefinitely effectiveSanta Ana, California 4/24/91.
Turner, Charles W., M.D. 00C150971 Suspended400 W. Freedom Way indefinitely effectiveAnaheim, California 4/24/91.
Turner, Dorothy M. 00A175890 Suspended4225 Saviers Road indefinitely effectiveOxnard, California 4/24/90.
Udall, John A. 000G54770 Suspended17821 Pioneer Boulevard indefinitely effectiveArtesia, California 10/8/97.
Uhley, Milton H. 00C101220 Suspended360 North Bedford Drive indefinitely effectiveBeverly Hills, California 9/26/96.
Umansky, Michael R. A42790 Suspended6363 Wilshire Boulevard, indefinitely effective Suite 300 2/07/03.Los Angeles, California
Unger, Jeffrey R. G45569 Suspended12716 Central Avenue indefinitely effectiveChino, California 9/11/00.
Unite, Anselmo Florido A25033 Suspended210 Oak Drive South, indefinitely effectiveSuite 201 08/31/00.Lake Jackson, Texas
Uranga, Victor Manuel 00A305020 Suspended Miramontes indefinitely effective374 H Street, Suite 201 04/19/00.Chula Vista, California
Ury, George A., M.D. 000C65500 Suspended511 Highland Avenue indefinitely effectiveNational City, California 1/26/83.
Utz, John Paul C29805 Suspended6402 East Shepherd indefinitely effective Hills Drive 05/12/04.Tucson, Arizona
Vacio, Frank H. 000E17550 Suspended25616 North Estoril Street indefinitely effectiveValencia, California 03/13/00.
Vagshenian, Gregory S. G26335 Suspended1137 Challenger indefinitely effectiveAustin, Texas 2/15/02.
Valcarcel, Jorge A. A36786 Suspended5101 Florence Avenue, indefinitely effectiveSuite 7 3/7/02.Bell, California
Physician ProviderNumber
Valdepenas, Edwin B. 21173 Suspended1205 Positas Road indefinitely effectiveChula Vista, California 09/20/00.
Valdez, Luis SuspendedCaminito de la Loma 12250 indefinitely effectiveTijuana, Baja California 09/20/00.
Valdez, Romulo C C38178 Suspended4 Laurel Lane indefinitely effectiveAmherst, New Hampshire 11/12/04. and12 East San Miguel DriveChula Vista, California
Valdivia, Rodolfo C. USA036140 Suspended3710 Alameda Avenue USA078570 indefinitely effectiveEl Paso, Texas 5/21/01.
Valenton, Roberto N. A34485 Suspended355 S Madison Avenue, #201 indefinitely effectivePasadena, California 3/11/02.
Vallejo, Arthur, M.D. 64836 Suspended9560 Maple Street indefinitely effectiveBellflower, California 8/23/2007. and17027 Clark AvenueBellflower, California and3650 South Street, #210Lakewood, California andP.O. Box 6289Lakewood, California and21081 S. Western Avenue, #250Torrance, California
Vannix, George L. A18549 Suspended451 North Ventura Road, indefinitely effectiveSuite #200 7/8/04.Port Hueneme, California
VanDerStuyf, James Gene 00G473800 Suspended16291 Countess Drive 00G473801 indefinitely effectiveHuntington Beach, California 8/20/98.
Van Doren, John Derrick G60750 Suspended17101 Armstrong Avenue, indefinitely effectiveSuite #201 7/25/2005.Irvine, California and1205 East North StreetManteca, California
Van Every, David 000G63680 Suspended456 W. 10th Street indefinitely effectiveClaremont, California 6/6/94.
Vangsgard, Gerald E., M.D. 00A220920 Suspended24235 San Pedro Lane indefinitely effectiveCarmel, California 10/2/91.
1 – Medi-Cal Suspended and Ineligible Provider ListSeptember 2007
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Physician ProviderNumber
Vazquez, Adrian SuspendedCalle Jupiter #9209 indefinitely effectiveCol. Sanchez Jaboada 09/20/00.Tijuana, Baja California
Vega, Julio Cesar, M.D. 00A334290 Suspended1 Tattersall 00A334291 indefinitely effectiveLaguna Niguel, California 00A334292 8/28/90.
Velez, David 00G388900 Suspended800 Third Street 00G388901 indefinitely effectiveMarysville, California 8/15/96.
Ventura, Ones Adviento A48324 Suspended1921 Calle Dulce indefinitely effectiveGlendale, California 3/27/2007. and7024 Seville Avenue,Suite EHuntington Park, California and1701 East McFadden Avenue,Suite DSanta Ana, California and3747 East Anaheim StreetLong Beach, California and8015 A & B Long Beach BoulevardSouth Gate, California
Ver Hoeve, Paul E. A45358 Suspended8851 Center Drive, #404 indefinitely effectiveLa Mesa, California 3/20/02.
Vespe, John R. G72675 Suspended5103 South Mill Avenue, indefinitely effective#170 8/15/01.Tempe, Arizona
Vicencio, Vaila Sison 00A414810-1 Suspended20960 East Walnut indefinitely effectiveCanyon Road 09/01/99.Walnut, California
Vicencio, Violeta B. A39857 Suspended111 East 220th Street, indefinitely effectiveSuite A 3/11/02.Carson, California
Vida, Alain Martin 00A304790 Suspended16440 Adron Street 00A304791 indefinitely effectivePacific Palisades, California 00A304792 1/27/99.
00A30479300A30479400A30479500A304796
Physician ProviderNumber
Vida, Martin Alain A30479 SuspendedAvenue Beau Sejour 9 indefinitely effective1410 Waterloo, Belgium 01/20/99. and15340 Devonshire Street,Suite 7Mission Hills, California and6908 Santa Fe AvenueHuntington Park, California and10011 Orr and Day RoadSanta Fe Springs, California and1514 Sycamore AvenueSanta Ana, California and12554 Central AvenueChino, California and2410 W. 3rd StreetLos Angeles, California And3831 Hughes Avenue,Suite 504Culver City, California
Vidricksen, Karl 00G353240 Suspended692 Main Street indefinitely effectiveTulelake, California 4/24/90.
Viguri, Juan J., M.D. 00A345640 Suspended2937 Beyer Boulevard indefinitely effectiveSan Diego, California 8/28/90.
Villamizar, Alfonso 00A348980 Suspended161 South Arden 00A348981 indefinitely effective Boulevard 00A348982 11/26/99.Los Angeles, California 00A348983
00A348984
Villarta, Antoni Quides A37598 Suspended4305 Ridgewood Drive indefinitely effectivePittsfield, Michigan 07/07/00.
Vincent, Robert Allen C35853 Suspended5725 Kilkenny Place indefinitely effectiveFitchburg, Wisconsin 02/04/04.
Vivanco, Felipe L. A43235 Suspended825 Hibiscus Court indefinitely effectiveCorona Del Mar, California 4/20/2006. and1901 Westcliff Drive, Suite #2Newport Beach, California
Vo, Phuoc Huu A51044 Suspended14213-14217 S. Inglewood indefinitely effectiveHawthorne, California 11/23/2004.
Vo, Thoi 00A399430 Suspended14041 S. Prarie Avenue indefinitely effectiveHawthorne, California 12/16/87.
1 – Medi-Cal Suspended and Ineligible Provider ListSeptember 2007
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Physician ProviderNumber
Vo, Thuong, M.D. 00A378510 Suspended9081 Bolsa Avenue indefinitely effectiveWestminster, California 1/22/87.
Voelker, Robert L. 00A143790 Suspended134 Muir Road indefinitely effectiveMartinez, California 2/17/97.
Vorperian, Adelina 50390 Suspended aka: Voperian, Adelina indefinitely effective1215 South Central 1/28/2007. AvenueGlendale, California and610 North Central Avenue, Suite #202Glendale, California
Vorperian, Kevork C50258 Suspended1215 South Central indefinitely effective Avenue 1/10/2007.Glendale, California and610 North Central Avenue,Suite #202Glendale, California and6730 White Oak Avenue,Suite AVan Nuys, California
Vostinak, William J. 00G444810 Suspended7919 Zenobia Street XPY083530 indefinitely effectiveWestminster, Colorado 2/6/96.
Vu, Thuc-Panh, T., M.D. 00A365640 Suspended560 E. Saint John Street indefinitely effectiveSan Jose, California 10/18/85.
Vu, Uong V., M.D. 00A359580 Suspended6959 Linda Vista Road indefinitely effectiveSan Diego, California 9/25/85.
Vu, Uong Van A35958 Suspended7110 Rock Valley Court indefinitely effectiveSan Diego, California 05/19/04.
Vuu, Tran N., M.D. 00A398940 Suspended2525 W. 17th Street indefinitely effectiveSanta Ana, California 5/30/85.
Wachs, Steven B., M.D. 00G272630 Suspended503 Vendola Drive indefinitely effectiveSan Rafael, California 7/5/77.
Wade, Mark Robert G47936 Suspended7205 Wolf River Boulevard, indefinitely effectiveSuite 203 01/20/04.Germantown, Tennessee
Wafa, Michael Fahmy A26448 Suspended9985 Sierra Avenue indefinitely effectiveFontana, California 5/15/2006.
Physician ProviderNumber
Wagner, Richard Stephen A33255 SuspendedRoute 2, Box 19 indefinitely effectiveCibola, Arizona 02/12/03.
Wakefield, John C., M.D. 00A218400 Suspended5150 Graves Avenue 00A218401 indefinitely effectiveSan Jose, California 12/23/82.
Waldron, Gail 00G114830 Suspended2470 E. Street indefinitely effectiveSan Diego, California 4/20/99.
Walker, Judith 00G452120 Suspended1285 Valdivia Way indefinitely effectivePalm Springs, California 2/15/96.
Walker, Robert M., M.D. 00C262540 Suspended815 South Central Avenue, #2 indefinitely effectiveGlendale, California 4/13/82.
Walker, Samuel R. C25783 Suspended24245 Elise Court indefinitely effectiveLos Altos Hills, California 8/22/01.
Waltuch, Theodore L. 00G523150 Suspended400 W. Forest, #131 00G523151 indefinitely effectiveCoalinga, California 11/21/00.
Waltuch, Theodore L. 00G523150 Suspended2171 Martinique Lane 00G523151 3/18/99Oxnard, California for 5 years.
Wang, Hugh Hankwang G8475 Suspended2700 Grant Street, indefinitely effectiveSuite #200 10/20/05.Concord, California
Wang, Jiing Tsong A32418 Suspended11511 Garvey Avenue indefinitely effectiveEl Monte, California 9/7/05.
Ware, Winthrop A24528 Suspended6150 North Colonial Avenue indefinitely effectiveFresno, California 10/21/03.
Warin, Adul 00A300440 Suspended1712 N. Tulare Way indefinitely effectiveUpland, California 11/22/93.
Warwick, Scott William G76469 Suspended908 South Lake Drive indefinitely effectiveWatertown, South Dakota 07/22/99. and400 East Main Street, Suite 200Stockton, California andFresno & R StreetsFresno, California
Washington, G. Kenneth, 00C320340 SuspendedM.D. 00C320341 indefinitely effective2628 El Camino Avenue 5/27/82.Sacramento, California
1 – Medi-Cal Suspended and Ineligible Provider ListSeptember 2007
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Physician ProviderNumber
Washington, Patricia A. A43579 Suspended aka: Sonyika, Patricia W. indefinitely effective19301 Jasper Hill Road 1/20/02.Trabuco Canyon, California
Watson, Lloyd, M.D. 00A207190 Suspended23248 Barton Road indefinitely effectiveColton, California 6/4/91.
Watkins, William Eugene C36219 Suspended7704 Caminito Sierra, indefinitely effectiveApt. T101 05/27/04.Carlsbad, California and/or217 Escondido Avenue,Suite 5Vista, California
Watson, Paul Morris A19202 Suspended1689 North Marian Avenue indefinitely effectiveThousand Oaks, California 03/08/00. and250 North 1st StreetBlythe, California
Watson, Standish J. 00A111650 Suspended6535 Maui Court 00A111651 indefinitely effectivePlacerville, California 9/11/96.
Way, Mau Sun 00A351100 Suspended2127 N. Tulare Court 00A351101 indefinitely effectiveUpland, California 1/18/97.
Webber, Barry R. Suspended1220 N. Whitnall Highway indefinitely effectiveBurbank, California 12/9/96.
Weber, Glenn Allan 00C373810 Suspended4732 Courtland Lane indefinitely effectiveCarmichael, California 6/28/00.
Weddle, Joseph L. A22229 Suspended203 Mission Street indefinitely effectiveCashmere, Washington 05/20/04.
Weil, Mitchell Suspended122 S. El Camino Real, indefinitely effective#327 3/14/96.San Clemente, California
Weinberger, Mark Steven G69777 Suspended2001 4th Avenue indefinitely effectiveSan Diego, California 5/10/2005.
Weiss, Mortimer M. 000C70100 Suspended145 A North McDowell indefinitely effective Boulevard 10/1/92.Petaluma, California
Weiss, Richard Alan G18474 Suspended23370 Mercantile Road indefinitely effectiveBeachwood, Ohio 7/14/05. and1911 East Center StreetAnaheim, California
Physician ProviderNumber
Weiss, Richard Alan G18474 Suspended23370 Mercantile Road indefinitely effectiveBeachwood, Ohio 9/28/2004. and10786 Missouri Avenue,Apartment #7Los Angeles, California and3307 South Grand AvenueLos Angeles, California and947 Tiverton AvenueLos Angeles, California
Welch, John R., M.D. 00C221000 Suspended505 N. Mollison 00C221001 indefinitely effectiveEl Cajon, California 2/15/85.
Wells, Robert N. A22094 Suspended5359 N. Fresno Street, indefinitely effectiveSuite 101-F 7/27/01.Fresno, California
West, Brian R. 65175 Suspended95 Scripps Drive indefinitely effectiveSacramento, California 12/5/2005. and2 Medical Plaza Drive, #130Roseville, California and701 E. 28th Street, #300Long Beach, California
Westfall, Robert E., M.D. 00A122970 Suspended2702 Dana Street indefinitely effectiveBerkeley, California 2/14/96.
Westing, Richard H., M.D. 00G577440 SuspendedP.O. Box 7663 indefinitely effectiveSan Jose, California 12/31/90.
Wetsman, Herman Eric 20A3976 Suspended aka: Westman, Eric indefinitely effective dba: Alvarado Ear, Nose 05/16/03. & Throat Associates Alvarado Voice and Speech Center San Diego Sinus Surgery Center San Diego Laser Center7229 Country Club DriveLa Jolla, California and6386 Alvarado Court, Suite 201San Diego, California
Westphal, Louetta G43635 Suspended Kannenberg indefinitely effective aka: Kannenberg, Louetta May 12/25/02. Powell, Louetta May Hewitt, Louetta Kannenberg Hewitt, Loetta M.468 North Camden DriveBeverly Hills, California
Whang, Chull C40630 Suspended107 West Mesa Avenue, #3 indefinitely effectiveGallup, New Mexico 12/18/02.
1 – Medi-Cal Suspended and Ineligible Provider ListOctober 2007
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Number
White, Arthur Hebert G12017 Suspended1850 Sullivan Avenue indefinitely effectiveDaly City, California 06/03/04. and2840 Long Beach Boulevard,Suite 410Long Beach, California
White, Harold W. 00C118880 Suspended33 Vista Way indefinitely effectiveFairfax, California 7/10/92.
White, James H., M.D. 00C304490 Suspended1401 Avocado Avenue, indefinitely effective#305 5/6/91.Newport Beach, California
White, Marvin Eugene 00G446070 SuspendedP.O. Box 3289 indefinitely effectiveModesto, California 4/19/96.
Whitehall, Judith GFE Suspended15 Woodward Court 62926 indefinitely effectiveCrockett, California 4/20/06.
Whittier, William, M.D. 00C232720 Suspended9348 Santa Monica Boulevard indefinitely effectiveBeverly Hills, California 8/31/80.
Wigfall, Jay, M.D. 00C408820 Suspended1129 Grand Avenue indefinitely effectiveSacramento, California 5/9/90.
Wilkie, Orman L. 00G238210 Suspended6412 Crafton Avenue indefinitely effectiveBell, California 11/24/91.
Wilkie, Orman L. 00G238211 Suspended11518 S. Garvey Avenue indefinitely effectiveEl Monte, California 11/24/91.
Wilkie, Orman L. 00G238212 Suspended18102 Irvine Boulevard, Suite 21 indefinitely effectiveTustin, California 11/24/91.
Wilkie, Orman L. 00G238213 Suspended2740 Bristol indefinitely effectiveSanta Ana, California 11/24/91.
Williams, Aubrey D. 00A291060 Suspended6170 Thornton Avenue indefinitely effectiveNewark, California 6/29/89.
Williams, David K. 00C403120 SuspendedP.O. Box 2041 indefinitely effectiveLondon, WIA IGU 2/14/96.
Williams, Elsworth A24406 Suspended Pearl, Jr. indefinitely effective945 East Holt Avenue, 8/20/2006.Apartment #EPomona, California
Physician ProviderNumber
Williams, Fortune J. A31497 Suspended13763 Campus Drive indefinitely effectiveOakland, California 9/20/05.
Williams, Mark Steven 00G444450-1 Suspended1855 White Oak Drive indefinitely effectiveMenlo Park, California 07/08/99.
Williams, Noel Alton 00A186290 Suspended1399 Ygnacio Valley Road, indefinitely effectiveSuite 7 9/20/98.Walnut Creek, California
Williams, Sam, Jr. 00C247821 Suspended286 Euclid Avenue, #308 indefinitely effectiveSan Diego, California 3/28/92.
Williams, William E. 00G594570 Suspended2701 Maxwell Avenue 00G594571 indefinitely effectiveOakland, California 1/14/98.
Williamson, William T., M.D. 00A089640 Suspended720 Brookside, #4 indefinitely effectiveRedlands, California 2/8/88.
Williamson, William T. 00A089640 Suspended650-3 Church Place indefinitely effectiveRedlands, California 11/20/97.
Willis-Cumby, La Vonne C41645 Suspended Theresa indefinitely effective aka: Willis, LaVonne T. 08/26/04. Willis, LaVonne H.311 North Robertson Boulevard, Suite 825Beverly Hills, California and3737 East Century BoulevardLynwood, California and5529 South StreetLakewood, California and1127 Wilshire Boulevard,Suite 1414Los Angeles, California and1078 Atlantic AvenueLong Beach, California and9375 San Fernando RoadSun Valley, California
Winckel, August 00A168030 Suspended2216 Santa Monica Boulevard indefinitely effectiveSanta Monica, California 12/2/85.
Winsauer, Henry J. 00C383130 Suspended8328 Caminito Helecho 00C383131 indefinitely effectiveLa Jolla, California 9/18/99.
Winstead, Arthur III, M.D. 00C375630 Suspended2101 Alexian Drive, #108 00C375631 indefinitely effectiveSan Jose, California 8/22/92.
1 – Medi-Cal Suspended and Ineligible Provider ListSeptember 2007
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Physician ProviderNumber
Winstead, Arthur III, M.D. 00C375632 Suspended1661 Burdette Drive, indefinitely effectiveBuilding #1, Suite #B 8/22/92.San Jose, California
Winstead, Arthur III, M.D. 00C375633 Suspended dba: Apsara-Asian indefinitely effective Family Clinic 8/22/92.2232 N. El Dorado, #BStockton, California
Winston, Burton 00C267280 Suspended1733 North Palm Canyon indefinitely effectivePalm Springs, California 7/15/91.
Winter, Virginia Kathleen C43124 Suspended5055 N.E. Elliott Circle, indefinitely effective#204Corvallis, Oregon 05/14/03.
Winters, Kenneth B. 00A331390 Suspended112 South East 17th 00A331391 indefinitely effective Street, W116 4/16/01.Santa Ana, California
Wintle, Keith A., M.D. 020A33500 Suspended9740 Magnolia Avenue 020A33501 indefinitely effectiveSantee, California 2/19/87.
Wise, Leslie Eugene A32748 Suspended2366 Bayfarm indefinitely effectiveNewport Beach, California 9/3/02.
Wittig, John H. 00A258960-01 Suspended4327 Rous Street indefinitely effectiveSan Diego, California 4/20/00.
Wolach, Marc D. A42152 Suspended1601 25th Avenue indefinitely effectiveGreeley, Colorado 10/14/03.
Woldenberg, Lee S., M.D. 00G155810 Suspended1019 S. LaBrea indefinitely effectiveLos Angeles, California 11/12/86.
Wolfe, Gerald L. 00AX44190 Suspended15074 Huntington Gate 00AX44191 indefinitely effective Drive 6/18/98.Poway, California
Wonderlick, Eugene Lyle C28181 Suspended36100 B Highway 1 indefinitely effectiveGualala, California 5/3/04.
Wong, Donald G., M.D. 00G100710 Suspended818 Jackson Street, #202 00G100711 indefinitely effectiveSan Francisco, California 3/5/88.
Wong, George S. 00A181440 Suspended27171 Caloroga Avenue, 00A181441 indefinitely effective#100 00A181442 7/22/96.Hayward, California
Wong, Leland Tracy G72850 Suspended628 San Antonio indefinitely effectiveLong Beach, California 4/20/99.
Physician ProviderNumber
Woodburn, Richard 00A265670 Suspended115 Westcourt Lane 00A265671 indefinitely effectiveSan Antonio, Texas 1/9/95.
Woods, Kenneth Bruce G39798 Suspended402 Sunrise Avenue indefinitely effectiveRoseville, California 4/2/02.
Workman, Allen Edson G19120 Suspended799 Buzianis Way indefinitely effectiveTooele, Utah 3/28/02.
Worstell, Craig S. Suspended1213 Navlet Court indefinitely effectiveSunnyvale, California 1/5/97.
Wright, Lucien J. 00C179870 Suspended 601930 Myrtle Avenue days effectiveEureka, California 9/21/92.
Wu, Ching Cheng A36293 Suspended aka: Kenneth C. Wu indefinitely effective9 Upland Terrace 06/07/00.Allegany, New York
Wulffson, Robin L. 00A224610 Suspended933 Newbury Street 00A224611 indefinitely effectiveRip, Wisconsin 3/26/97.
Xuan, Tuan A. Hoang Suspended1650 Broadway Avenue, Apt. K indefinitely effectiveSeaside, California 4/6/97.
Yabut-Baluyut, A42583 Suspended Fredesminda L. indefinitely effective25552 Saddle Rock Place 9/6/02.Laguna Hills, California
Yagoda, Charles L. G29486 Suspended604 Seneca Street indefinitely effectiveOnieda, New York 9/11/01.
Yaldua, Ramon 00A358690 Suspended336 Oxford Street, Suite 203 indefinitely effectiveChula Vista, California 3/13/95.
Yankasammy, Samuel 00C381840 Suspended14071 Flower, #5 00C381841 indefinitely effectiveGarden Grove, California 8/22/96.
Yannessa, Noel A. G10922 Suspended5170 North Sabino Hills Drive indefinitely effectiveTucson, Arizona 03/24/03.
Yap-Chiongro, Basilio 00A228800 Suspended2742 Seafarer Court indefinitely effectiveWaldport, Oregon 9/28/94.
Yaqub, Nizar A. A29913 Suspended680 East Romie Lane indefinitely effectiveSalinas, California 03/07/03.
1 – Medi-Cal Suspended and Ineligible Provider ListSeptember 2007
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Physician ProviderNumber
Yazdgerdi, Daryoush C39626 Suspended384 Stonewood Drive indefinitely effectiveVacaville, California 9/10/99.
Yazdi, Houshang E. A30109 Suspended11550 Indian Hills Road, indefinitely effective#241 01/05/04.Mission Hills, California
Yedidsion, David 00A384120 Suspended aka: Davoud Yedidsion 7/20/99FCI Sheridan for 20 years.27072 Ballston RoadSheridan, Oregon
Yim, Kenneth 00G645250 Suspended751 S. Bascom 00G645251 indefinitely effectiveSan Jose, California 12/20/98.
Ying, Lloyd A28196 Suspended50300 Hanford Road indefinitely effectiveCanton, Michigan 4/6/00.
Yoonessi, Mahmood C50545 Suspended9 Bobbie Lane indefinitely effectiveWilliamsville, New York 11/27/01.
Young, Bing Hin A16561 Suspended27001 Calaroga Avenue indefinitely effectiveHayward, California 03/19/03.
Young, Joseph D. G10679 Suspended1846 Conejo Avenue indefinitely effectiveSan Luis Obispo, California 7/18/02.
Young, Richard Lane G44054 Suspended702 Waterway Drive SW indefinitely effectiveSunset Beach, North Carolina 7/8/02.
Younger, Carl B., M.D. 00A186310 Suspended10661 Riverside Drive indefinitely effectiveNorth Hollywood, California 1/1/79. Younger Psychiatric ZZZ73234Z Medical Group ZZZ41017Z
Yung, Sham 33830 Suspended aka: Sham, Yung indefinitely effective600 S. Lafayette Park, #150 7/31/2007.Los Angeles, California and8157 Santa Monica BoulevardWest Hollywood, California and1501 Agate StreetColton, California
Zaccheo, Jerald D. G38634 Suspended3620 Avery Court indefinitely effectiveTurlock, California 3/28/01.
Zaguirre, Jose 00A195322 Suspended18552 MacArthur indefinitely effectiveIrvine, California 6/5/89.
Physician ProviderNumber
Zahn, Albert 00A118002 Suspended1987 Shasta Street indefinitely effectiveBurney, California 12/3/91.
Zahn, Albert 00A118000 Suspended710 Wilshire Boulevard indefinitely effectiveSanta Monica, California 12/3/91.
Zahn, Albert 00A118001 SuspendedHighway 299 E indefinitely effectiveFall River Mills, California 12/3/91.
Zander, Alla A61985 Suspended23961 Calle De La indefinitely effective Magdalena, Suite 517 1/5/03.Laguna Hills, California
Zane, Murry F., M.D. 000G76680 Suspended16131 Whittier Boulevard indefinitely effectiveWhittier, California 7/12/85.
Zaresky, Stephen A., M.D. 00G438290 Suspended4740 Hoen Avenue indefinitely effectiveSanta Rosa, California 10/1/90.
Zelig, Harry 00G301280 SuspendedP.O. Box 7000 indefinitely effectiveCrescent City, California 5/20/99.
Zemelman, Harold A16458 Suspended4 Stirrup Road indefinitely effectiveRancho Palos Verdes, California 2/13/02.
Zevallos, Carlos A. C40546 SuspendedP.O. Box 625 indefinitely effectiveSun Valley, California 8/4/99.
Ziering, William H. G7842 Suspended4747 N. First Street indefinitely effectiveFresno, California 2/28/02.
Zilka, Ezeckiel A42725 Suspended10921 Wilshire Boulevard, indefinitely effectiveSuite 1114 9/20/01.Los Angeles, California
Zucker, Martin 00C130400 Suspended401 Pellertier Drive indefinitely effectiveSioux City, Iowa 12/11/95.
Zucker, Norman, M.D. 00G363940 Suspended1816 Florence Street indefinitely effectiveEnumclaw, Washington 6/24/91.
1 – Medi-Cal Suspended and Ineligible Provider ListSeptember 2007
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Physician Assistant ProviderNumber
Aparicio, Daniel Angel PA11991 Suspended1823 Luder Avenue indefinitely effectiveEl Monte, California 10/25/00.
Arenas, Arnolfo Carson, Jr. Suspended500 Oak Street, #105 indefinitely effectiveGlendale, California 10/19/00.
Austin, Kirk Jay PA10387 Suspended aka: Kirk Jay Tucker 6/17/98 Jay Austin for 5 years.1926 Brommer Street, #12Santa Cruz, California
Behrends, Gayle Ann PA13443 Suspended6 Longbourn Aisle 10/10/00Irvine, California for 5 years.
Bertoldo, Jill PA Suspended15935 Foothill Avenue 15085 indefinitely effectiveMorgan Hill, California 2/20/2006.
Bickel, Deborah Ann Suspended2819 Piedmont Avenue indefinitely effectiveBerkeley, California 10/7/97.
Castillo, Jose Francisco PA13205 Suspended aka: Chavez, Jose Francisco indefinitely effective531 Chardonnay Way 01/20/03.Hollister, California
Choi, Randy King PA-15088 Suspended63 South Roosevelt Avenue, #1 Indefinitely effectivePasadena, California 07/29/04.
Chudwumeka, Anene Suspended Alexander indefinitely effective18915 Godinho Avenue 6/28/2007.Cerritos, California
Cody, Judith W. 15217 Suspended17366 Hidden Valley Drive indefinitely effectiveWildwood, Missouri 6/20/2007.
Corrales, Enrique G. PA12428 Suspended2912 Niabell Place (Physician indefinitely effectiveModesto, California Assistant) 8/20/98.
Farquhar, Perry Gordon PA14561 SuspendedP.O. Box 81 PA10437 indefinitely effectiveMad River, California 04/20/03.
Freeman, Timothy Alan PA-10991 Suspended16787 Beach Boulevard, indefinitely effectiveApartment 525 7/20/04.Huntington Beach, California
Physician Assistant ProviderNumber
Fuentes, Jesus Mendez PA-13121 Suspended18130 Eucalyptus indefinitely effectiveHesperia, California 5/20/04.
Garcia, Jose Domingo PA10992 Suspended1716 East Almanac Drive indefinitely effectiveWest Covina, California 12/20/00.
Grantham, Robert Edwin PA11140 Suspended3409 Brisbane Avenue indefinitely effectiveBakersfield, California 5/20/01.
Green, Michael Dee PT20476 Suspended for aka: Michael D. Green 10 years effective1140 E Street, #39 3/18/99.Eureka, California
Hager, Leslie W. PA13552 Suspended431 North Morris indefinitely effectiveWest Covina, California 1018/01.
Haines, Jeffrey W. Suspended10453 Meadowcreek Drive indefinitely effectiveMoreno Valley, California 5/22/97.
Handly, Michael John PA11461 Suspended2302 Codding 10/10/00Modesto, California for 5 years.
Haya, Bab PA-13074 Suspended1436 West James Way indefinitely effectiveAnaheim, California 4/20/04.
Heath, Kendall Tyrone PA14177 Suspended9609 Par Place indefinitely effectivePico Rivera, California 9/20/04.
Hickman, James Murray PA-12960 SuspendedP.O. Box 493 indefinitely effectiveMt. Gilead, Ohio 04/09/01.
Hicks, Ricky PA-12721 Suspended15845 Dodrill Drive indefinitely effectiveHacienda Heights, California 06/19/03.
Ilouno, George Oranyelu Suspended aka: Ilound, George Oranveulo indefinitely effective1009 Fernrest Drive 01/13/01.Harbor City, California
Joseph, Lloyd Suspended1801 Blake Street indefinitely effectiveBerkeley, California 5/20/99.
1 – Medi-Cal Suspended and Ineligible Provider ListSeptember 2007
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Physician Assistant ProviderNumber
Josiah, Andrew PA12701 Suspended aka: Josiah, Andre Lahar indefinitely effective14729 Funston Avenue 01/20/04.Norwalk, California
King, Grant Marcus PA11127 Suspended704 Tonner Drive indefinitely effectivePomona, California 3/20/01.
Koehler, Pamela Rae PA13556 Suspended aka: Pamela Rae Staton 6/17/99 Pam Rae Staton for 10 years.2281 Dogwood RoadMcKinleyville, California
Lini, Megan Noreen PA-14080 Suspended4621 32nd Street, #1 indefinitely effectiveSan Diego, California 7/18/02.
Lynch, Chris PA12072 Suspended17066 Lorene Place indefinitely effectiveVictorville, California 07/12/99.
Macias, Carlos Orosco, Jr. PA13279 Suspended3697 Elford Drive indefinitely effectiveWhittier, California 04/20/00.
McKinin, Michael Lillis Suspended aka: McKinn, Michael indefinitely effective McKinnon, Michael 3/20/05.130 Donald DriveChico, California
Murray, Harry Lynn PA11607 Suspended2131 Locust Avenue indefinitely effectiveLong Beach, California 5/13/03.
Murray, Theodore PA14147 Suspended975 Lighthouse Avenue indefinitely effectivePacific Grove, California 10/02/00.
Peters, Paul PA12933 Suspended3400 Ben Lomond Place indefinitely effectiveLos Angeles, California 7/18/01.
Pinkston, Charles E. 14875 SuspendedP.O. Box 3685 indefinitely effectiveCerritos, California 8/29/2007.
Pugliese, William Francis Suspended2510 L West Mac Arthur indefinitely effective Boulevard 08/20/02.Santa Ana, California
Purdy, Kevin Paul Suspended c/o Michael P. Thorman, indefinitely effective Esq. 9/4/97.24301 Southland Drive, Suite 312Hayward, California
Physician Assistant ProviderNumber
Ramirez, Manuel PA14601 Suspended Deatocha indefinitely effective2362 Cline Street 7/20/2006.Firebaugh, California
Richardson, Stephen R. PA13144 Suspended4646 Morada Lane indefinitely effectiveStockton, California 1/4/02.
Robinson, Anne PA10576 Suspended aka: Lewis, Brenda Anne indefinitely effective210 South Locust Street 11/24/03.Inglewood, California
Sandoval, Patricia PTO-11828 Suspended aka: Arrington, Patricia indefinitely effective2071 Santa Clara Avenue 3/30/91.Alameda, California
Spence, Jason Keith PA-14404 SuspendedP.O. Box 426169 indefinitely effectiveSan Francisco, California 5/23/02.
Spencer, Brian Earl PA12373 Suspended3117 Greenbriar Drive indefinitely effectiveLas Vegas, Nevada 01/13/01.
Stewart, Kenneth Leslie PA11748 Suspended1429 East Palo Alto indefinitely effectiveFresno, California 6/21/01.
Stutzman, Laurie PA13014 Suspended15202 Turquoise Circle indefinitely effectiveChino Hills, California 3/20/05.
Suhr, Daniel A. PA14016 Suspended23411 Summerfield, #185 indefinitely effectiveAliso Viejo, California 01/13/01.
Williams, Coleen Suspended3336 West Shields Avenue, indefinitely effectiveApartment #201 9/14/05.Fresno, California
1 – Medi-Cal Suspended and Ineligible Provider ListSeptember 2007
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Physician Applicant ProviderNumber
LIordamova, Zoya Suspended12311 Chandler Boulevard, Unit 40 indefinitely effectiveNorth Hollywood, California 9/14/01.
Family Medicine
Nash, James Frank C51363 SuspendedP.O. Box 1136 indefinitely effectiveLake Arrowhead, California 4/20/06.
Osteopath
Allen, Daniel M. 20A6486 Suspended426 Neal Street indefinitely effectiveGrass Valley, California 9/20/2006.
Awad, Aziz F., D.O. 20A6241 SuspendedActive Care Medical Group indefinitely effective606 South Euclid Street 3/7/2006.Anaheim, California and9436 Slauson AvenuePico Rivera, California
Daly, James Edmond 20A5105 Suspended17629 Vierra Canyon Road indefinitely effectiveSalinas, California 2/24/2006.
Duffy, William T. 20A4425 Suspended8349 Reseda Boulevard, indefinitely effectiveSuite #D 3/2/2005.Northridge, California
Kurylowicz, Ronald A. Suspended4665 W. Pico Boulevard indefinitely effectiveLos Angeles, California 12/15/2006. and754 Washington BoulevardMarina Del Rey, California and330 5th AvenueVenice, California
Nguyen, Michael M. Suspended1069 Nicklaus Avenue indefinitely effectiveMilpitas, California 9/20/2006.
Osteopathic Physician and Surgeon
Latterman, Michael Scott 20A7200 Suspendedc/o 600 US Highway 27 DC#M40032 indefinitely effective South 10/19/2006.South Bay, Florida
Moon, Larry B. 20A6428 Suspended3510 Hecker Pass Road, indefinitely effectiveSuite #K 6/20/2006.Gilroy, California and250 North 1st StreetBlythe, California and160 East Artesia Street,Suite #150Pomona, California
Osteopathic Physician Providerand Surgeon Number
Sidhu, Darshan Singh A42788 Suspended8 Chablis Circle indefinitely effectiveSalinas, California 11/6/2000. and440 Greenfield Avenue,Suite #HHanford, California
Stone, Michael D. 20A5348 Suspended20122 Canyon Drive indefinitely effectiveYorba Linda, California 7/7/03. and1830 West Romneya DriveAnaheim, California
Cardiologist
Rosenthal, Bertram P. GFE10564 Suspended17158 Burbank indefinitely effective Boulevard 6/20/2006.Encino, California and2001 Santa Monica BoulevardSanta Monica, California and1225 15th StreetSanta Monica, California
Psychiatrist
Plastic and Reconstructive Surgeon
Sterling, Harley East, M.D. G7835 Suspended596 Brambles Way indefinitely effectiveOrange, California 6/20/2006. and301 West Bastanchury RoadFullerton, California and2720 North Harbor BoulevardFullerton, California
Pediatrician
Bhasin, Sunil Kumar G67327 Suspended909 North D Street, indefinitely effectiveSuite #14 6/20/2006.San Bernardino, California and9985 Sierra AvenueFontana, California
1 – Medi-Cal Suspended and Ineligible Provider ListOctober 2007