Look up the most recent NPI and PECOS records

Ealla Atari

Pediatrics

Allopathic & Osteopathic Physicians

3020 Childrens Way, San Diego, CA 92123-4223

PECOS Enrollment

Based on the most recent information from CMS, provider Ealla Atari is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 2:29 PM.

Profile Details

Provider ID
1194354837
Provider Type
Individual
Full Name
Atari, Ealla
Title
Dr.
Credential
MD

Gender
Female
Sole Proprietor
No
Enumeration Date
4/4/2020
Last Updated
9/19/2024

Contact Information

Practice Location

3020 Childrens Way, San Diego, CA 92123-4223

(858) 966-8800

Unlisted Fax

Mailing Location

3020 Childrens Way # Mc5003, San Diego, CA 92123-4223

(858) 309-6300

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 208000000X Primary	Description Pediatrics Allopathic & Osteopathic Physicians	License A186680 California

Ealla Atari

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Hansen, John C

Kaufhold, Marilyn Jean

Lee, Begem

Manriquez-Castillo, Erendira

Gracia, Michael Loy

Larrow, Annie Ngo

Rothman, Joshua Marc

Ayson, Nicole Mae Ketring

Giboney, Jennifer Christine

Vaidya, Kamala