San Diego County A California health plan that knows - Blue Shield of California

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A California health plan that knows
               San Diego County

            Provider Directory /Directorio de Proveedores
                      Blue Shield 65 Plus (HMO)
                               Date printed: May 2013
                                  Plan year: 2013

H0504_12_164 CMS Approved 08102012
Table of Contents
List of Hospitals ................................................................... p. v
Using This Directory............................................................ p. vii
Choosing Your PCP............................................................. p. viii
Changing Your PCP............................................................. p. viii
Important Information ......................................................... p. ix
Physician Groups
   Arch Health Partners ....................................................... p. 1
       Palomar Medical Center
       Pomerado Hospital
   San Diego Physicians Medical Group Central ................ p. 5
       Scripps Mercy Hospital San Diego Campus
   San Diego Physicians Medical Group Chula Vista .......... p. 9
       Scripps Mercy Hospital Chula Vista
       Scripps Mercy Hospital San Diego Campus
   San Diego Physicians Medical Group East County ........ p. 14
       Scripps Mercy Hospital San Diego Campus
   San Diego Physicians Medical Group North Coastal ...... p. 18
       Scripps Memorial Hospital Encinitas
   Vantage IPA San Diego .................................................. p. 24
       Palomar Medical Center
       Scripps Mem Hosp Encinitas
       Scripps Mercy Hospital Chula Vista
       Scripps Mercy Hospital San Diego Campus
Skilled Nursing Facilities .................................................... p. 37
Index ..................................................................................... p. 39

Information in this directory is current as of the date on the front
cover. Some network providers may have been added or removed
from our network after this directory was printed. Since information
changes often, a physician’s listing in this directory does not
guarantee that the physician is still in the network or accepting new
patients.

To get the most up-to-date information about network providers in
your area, please visit Find a Provider on blueshieldca.com or call
Blue Shield 65 Plus (HMO).

                                                                                                    i
Table of Contents, continued

                    Prospective Members
                    Please call your broker or call Blue Shield 65 Plus (HMO) at:
                    1-800-488-8000
                    1-800-595-0000 (TTY)
                    8:00 a.m. to 8:00 p.m. seven days a week

                    Current Members
                    Please call Member Services at:

                    1-800-776-4466
                    1-800-794-1099 (TTY)
                    7 a.m. to 8 p.m., seven days a week. Hours are 7 a.m. to 8 p.m.,
                    seven days a week, from October 1, 2012 through February 14,
                    2013. However, after February 14, your call will be handled by our
                    automated phone system on Saturdays, Sundays and holidays.

ii
Índice
Lista de hospitales............................................................... p. ix
Cómo utilizar este directorio .............................................. p. xvi
Cómo elegir a su PCP ......................................................... p. xvii
Cómo cambiar de PCP ........................................................ p. xviii
Información importante....................................................... p. xviii
Grupos de Médicos
   Arch Health Partners ....................................................... p. 1
       Palomar Medical Center
       Pomerado Hospital
   San Diego Physicians Medical Group Central ................ p. 5
       Scripps Mercy Hospital San Diego Campus
   San Diego Physicians Medical Group Chula Vista .......... p. 9
       Scripps Mercy Hospital Chula Vista
       Scripps Mercy Hospital San Diego Campus
   San Diego Physicians Medical Group East County ........ p. 14
       Scripps Mercy Hospital San Diego Campus
   San Diego Physicians Medical Group North Coastal ...... p. 18
       Scripps Memorial Hospital Encinitas
   Vantage IPA San Diego .................................................. p. 24
       Palomar Medical Center
       Scripps Mem Hosp Encinitas
       Scripps Mercy Hospital Chula Vista
       Scripps Mercy Hospital San Diego Campus
Centros de Enfermería Especializada................................ p. 37
Índice alfabético................................................................... p. 39

La información contenida en este directorio entrará en vigencia a
partir de la fecha indicada en la portada. Es posible que algunos
proveedores de la red hayan sido añadidos o eliminados de nuestra
red después de haberse impreso este directorio. Dado que la
información cambia a menudo, que un médico esté en la lista de este
directorio no garantiza que aún forme parte de la red o que acepte a
nuevos pacientes.

Para obtener la información más actualizada sobre los proveedores
de la red disponibles en su área, visite la sección Find a Provider
(Encuentre un Proveedor) en blueshieldca.com o llame a
Blue Shield 65 Plus (HMO).

                                                                                        iii
Índice, continuación

                       Futuros Miembros
                       Comuníquese con su corredor o llame a
                       Blue Shield 65 Plus (HMO) al:
                       1-800-488-8000
                       1-800-595-0000 (TTY)
                       De 8:00 a.m. a 8:00 p.m., todos los días de la semana

                       Miembros Actuales
                       Comuníquese con Servicio para Miembros al:

                       1-800-776-4466
                       1-800-794-1099 (TTY)
                       De 7:00 a.m. a 8:00 p.m., todos los días de la semana. El horario es
                       de 7 am a 8 pm, los siete días a la semana, del 1 de octubre de 2012
                       hasta el 14 de febrero 2013. Después de 14 de febrero, su llamada
                       será atendida por nuestro sistema telefónico automatizado los
                       Sábados, Domingos y dias Festivos.

iv
hospital index

      List of Hospitals found in this directory/
      Lista de hospitales que se encuentran en este directorio
                 Palomar Medical Center ..................................................................................... 1, 24
                 Pomerado Hospital .................................................................................................... 1
                 Scripps Mem Hosp Encinitas ................................................................................. 24
                 Scripps Memorial Hospital Encinitas .................................................................... 18
                 Scripps Mercy Hospital Chula Vista .................................................................. 9, 24
                 Scripps Mercy Hospital San Diego Campus ......................................... 5, 9, 14, 24

                                                                                                                                            v
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Using This Directory
The service area for           Guatay                           your Primary Care Physician
Blue Shield 65 Plus (HMO) is   Imperial Beach                   (PCP). The term "PCP" will be
San Diego County.              Jacumba                          used through this directory.
                               Jamul                            Generally, you must get your
This directory lists the       Julian                           health care coverage from
Blue Shield 65 Plus (HMO)      La Jolla                         your PCP. When you choose
provider network in San        La Mesa                          your PCP, you are also
Diego area. The following      Lakeside                         choosing the hospital(s) and
cities are part of the San     Lemon Grove                      specialty network affiliated
Diego service area and are     Lincoln Acres                    with the physician group.
included in this directory.    Mount Laguna
                               National City                     Blue Shield 65 Plus (HMO)
Alpine                         Oceanside                          PCPs, specialists, hospitals,
Bonita                         Pala                               clinics and urgent care
Bonsall                        Palomar Mtn                        centers are listed by
Borrego Springs                Pauma Valley                       physician group.
Boulevard                      Pine Valley
Camp Pendleton                 Potrero                           The hospital or hospitals
Campo                          Poway                              affiliated with the physician
Cardiff By The Sea             Ramona                             group are listed at the
Carlsbad                       Ranchita                           beginning of each physician
Chula Vista                    Rancho Santa Fe                    group section in this
Del Mar                        San Diego                          directory.
Descanso                       San Luis Rey
Dulzura                        San Marcos                        If you need to be
El Cajon                       San Ysidro                         hospitalized, your PCP will
Encinitas                      Santa Ysabel                       coordinate your admission
Escondido                      Santee                             to the hospital associated
Fallbrook                      Solana Beach                       with your physician group. If
                               Spring Valley                      more than one hospital is
                               Tecate                             associated with the
                               Valley Center                      physician group, your PCP
                               Vista                              will determine which hospital
                               Warner Springs                     is most appropriate for your
                                                                  care.
                               To get detailed information
                               about your health care            PCPs are listed
                               coverage, please see your          alphabetically under one of
                               Evidence of Coverage.              the following categories:
                                                                  Family Practice, General
                               You will have to choose one of     Practice, Internal Medicine,
                               our network providers who are      and OB/ GYN. Your PCP will
                               listed in this directory to be     provide or coordinate all

                                                                                             vii
Using This Directory, continued

  your covered medical care          a specialist associated with       physician group before you
  while you are a member of          the network physician              can be treated by a
  our plan.                          group.                             specialist, except for routine
                                                                        women's health care as
  PCPs who are not                   If your specialist                 described below and in your
  accepting new patients are         recommends that you                Evidence of Coverage.
  listed under the category          continue to see him or her
  Accepting Current Medicare         for more services, those         2.Call the office of the PCP
  Patients Only. You may             services may need to be            you have selected to make
  choose a PCP in this               authorized by your network         sure that he or she is
  category only if you are new       physician group.                   accepting new Blue Shield
  to Blue Shield 65 Plus                                                65 Plus (HMO) patients and
  (HMO) and are currently a         Urgent Care facilities             for answers to any
  patient of that physician or       affiliated with your physician     questions you may have
  changing to a new                  group are listed under             about the doctor (e.g. office
  physician group and that           Urgent Care Centers. You           hours, availability evenings
  physician is also part of the      may use these Urgent Care          and/or weekends and
  new physician group.               Facilities or any other            educational background).
                                     Urgent Care facility in your
  This directory represents          Blue Shield 65 Plus (HMO)        3.Enter the ID number of the
  only a portion of our service      service area if you need           PCP you have chosen in
  area and is not a full list of     urgent medical care when           the appropriate box on your
  our network providers. If          your PCP's office is closed.       Blue Shield 65 Plus (HMO)
  you don't find the provider                                           enrollment form.
  you're looking for or would       Plan pharmacies are not
  like to see a complete listing     listed in this directory. You    If you need help choosing a
  of the providers available to      may request a list of these      PCP, please call us for
  you by ZIP code or area,           facilities by calling our        assistance at one of the
  please call Blue Shield 65         Member Services                  numbers listed on the first
  Plus (HMO) at the number           Department or by going to        page of this directory.
  above to have a list sent to       Find a Provider on
  you. You may also visit Find       blueshieldca.com.                Changing your current PCP
  a Provider on                                                       is easy
  blueshieldca.com to              To choose your PCP, follow
  search or confirm that a         these simple steps                 You may change your PCP at
  provider is part of our                                             any time. However, if you are
  network.                         1.Choose the doctor you want       under inpatient care in the
                                     as your PCP from the list        hospital or you are in the
 Affiliated specialists are         below.                           middle of a course of
  listed in alphabetical order                                        treatment with your PCP or a
  under their specialty. If your    Note: If you are interested in    specialist, we recommend
  PCP feels you need more           a particular specialist,          that you do not change your
  specialized treatment, he or      make sure he or she is in         physician/physician group
  she will refer you, upon          the same physician group          until you are discharged or
  physician group approval, to      as the PCP you select. You        complete your course of
                                    will need an authorized           treatment.
                                    referral from your PCP's

viii
Using This Directory, continued

If you decide to change your       Important Information               If you need care in an
PCP, simply call Member                                                 emergency, get medical
Services and we will check to       If possible, call your PCP         help as quickly as possible.
make sure the doctor you             before you seek medical            Call 911 for help or go to the
choose is accepting new              care. If you go to a doctor,       nearest emergency room.
patients. You should ask             hospital or other provider         You do not need to get
whether the new PCP you are          without the approval of your       permission first from your
selecting has a referral             PCP except in an                   physician or other network
relationship with any specialist     emergency or when you              provider.
you are currently seeing. We         need urgent care,
will make the change for you,        out-of-area renal dialysis         A medical emergency is
tell you over the phone when         (within the United States), or     when you believe that your
this change will go into effect,     paying any charges for             health is in serious danger
and send you a new member            these certain gynecological        when every second counts.
ID card.                             care or other self-referred        A medical emergency
If you call by the 15th of the       services, you will be              includes severe pain, a bad
month, your transfer to a new        responsible for services.          injury, a serious illness, or a
PCP will be effective on the         Neither Original Medicare          medical condition that is
first day of the following           nor Blue Shield 65 Plus            quickly getting much worse.
month.                               (HMO) will pay for
                                     non-emergency services or          Make sure that Blue Shield
Sometimes a PCP, specialist,         non-urgently needed care           knows about your
or clinic you are using might        without the prior                  emergency because your
leave the plan. If this happens,     authorization of your PCP.         physician will need to be
you will have to switch to                                              involved in following up on
another network doctor. We           Urgent Care refers to a            your emergency care.
will notify you if this happens      non-emergency situation
and make sure you continue to        where you are temporarily          You or someone else should
have access to all services in       absent from the Plan's             call to tell your physician
the Blue Shield 65 Plus (HMO)        authorized service area, you       about your emergency care
benefit package.                     need medical attention right       as soon as possible,
                                     away for an unforeseen             preferably within 48 hours.
If you are a female member           illness, injury or condition,      The number to call is located
who prefers to see an                and it isn't reasonable given      on your Blue Shield 65 Plus
OB/GYN for your routine              the situation for you to           (HMO) member ID card.
women's health care                  obtain medical care through
(mammograms, pap tests, and          the Plan's provider network.       What if you need medical
pelvic and breast exams), you        Under unusual and                  attention right away for an
can make an appointment with         extraordinary                      unforeseen illness or
any OB/GYN listed under your         circumstances, care may be         injury, but your health is
network physician group              considered urgently-needed         not in serious danger? If
without a referral from your         when the member is in the          you need medical help
PCP.                                 service area but the provider      immediately but your health
                                     network of the Plan is             is not in serious danger, the
                                     temporarily unavailable or         help you need is called
                                     inaccessible.                      "urgently needed care". If

                                                                                                     ix
Using This Directory, continued

    you are in your plan's             identified with the symbol       applicable
    service area please call           participate in the Leapfrog      copayment/coinsurance
    your PCP or, if your               Group, an independent            amount(s).
    physician's office is closed,      California program that
    go to the urgent care facility     works to implement three
    listed in this directory.          key practices that have
                                       been shown to improve            Blue Shield 65 Plus (HMO)
    If you are outside the             patient safety. Leapfrog         Claims Department
    service area, first call your      hospitals 1) do computer         P.O. Box 5014
    PCP whenever possible. If          checks on prescriptions to       Woodland Hills, CA
    you are treated for an             avoid drug interactions; 2)      91365-9623
    urgent care condition while        have a full-time physician
    you are outside the service        specialist on staff in all
    area we prefer that you            intensive care units; and 3)
    return to the service area to      perform high-risk surgical
    get follow-up care through         procedures, such as heart
    your PCP. However, we will         surgery, only when certain
    cover follow-up care that          quality criteria are met.
    you get from non-network
    providers outside the             If you need skilled
    service area as long as the        nursing, transitional care
    care you are getting still         or specialized services,
    meets the definition of            your PCP will arrange for
    "urgently needed care".            you to be transferred to a
                                       subacute care facility
 Some hospitals and other             contracting with Blue Shield
  providers do not provide             or another facility with which
  one or more of the                   he or she is affiliated. You
  following services that              may request a list of these
  may be covered under your            facilities by calling our
  plan contract and that you           Member Services
  might need: family planning;         department.
  contraceptive services; and
  sterilization, including tubal      If you receive a bill from
  ligation at the time of labor        any non-network provider
  and delivery. To ensure that         for covered services such
  you can obtain the                   as emergency or urgently
  healthcare services that you         needed care or out-of-area
  need, call our Member                renal dialysis services,
  Services department for              please do not pay it.
  assistance.                          Instead, please send it to us
                                       at the following address and
 Some hospitals                       we will pay the covered
  participate in an                    amount, minus any
  independent quality
  program. Hospitals

x
Blue Shield 65 Plus (HMO)Cómo utilizar este directorio
El área de servicio para         Guatay                         Tendrá que elegir uno de
Blue Shield 65 Plus (HMO)        Imperial Beach                 nuestros proveedores de la
abarca el condado de San         Jacumba                        red que se incluyen en este
Diego.                           Jamul                          directorio para que sea su
                                 Julian                         Médico de Atención Primaria
Este directorio incluye la red   La Jolla                       (PCP, por sus siglas en
de proveedores de                La Mesa                        inglés). Se utilizará el término
Blue Shield 65 Plus (HMO) en     Lakeside                       "PCP" en todo este directorio.
el área del condado de San       Lemon Grove                    Por lo general, usted debe
Diego. Las siguientes            Lincoln Acres                  recibir su cobertura de
cuidades forman parte del        Mount Laguna                   atención de la salud por medio
área de servicio del condado     National City                  de su PCP. Cuando usted
de San Diego y están             Oceanside                      elige a su PCP, también está
incluidas en este directorio.    Pala                           eligiendo el (los) hospital(es) y
                                 Palomar Mtn                    la red de especialistas
Alpine                           Pauma Valley                   afiliados al grupo de médicos.
Bonita                           Pine Valley
Bonsall                          Potrero                        • Los PCP, especialistas,
Borrego Springs                  Poway                            hospitales, clínicas y centros
Boulevard                        Ramona                           de atención urgente de
Camp Pendleton                   Ranchita                         Blue Shield 65 Plus (HMO)
Campo                            Rancho Santa Fe                  están incluidos por grupo de
Cardiff By The Sea               San Diego                        médicos.
Carlsbad                         San Luis Rey
Chula Vista                      San Marcos                     • El hospital o los hospitales
Del Mar                          San Ysidro                       afiliados al grupo de
Descanso                         Santa Ysabel                     médicos están incluidos al
Dulzura                          Santee                           comienzo de cada sección
El Cajon                         Solana Beach                     correspondiente a los
Encinitas                        Spring Valley                    grupos de médicos de este
Escondido                        Tecate                           directorio.
Fallbrook                        Valley Center
                                 Vista                          • Si necesita ser
                                 Warner Springs                   hospitalizado, su PCP
                                                                  coordinará su ingreso al
                                 Para obtener información         hospital que esté asociado
                                 detallada sobre su cobertura     con su grupo de médicos. Si
                                 de atención de la salud,         hay más de un hospital
                                 consulte su Evidencia de         asociado al grupo de
                                 Cobertura.                       médicos, su PCP
                                                                  determinará cuál es el
                                                                  hospital más apropiado para
                                                                  su atención.

                                                                                               xi
Cómo utilizar este directorio, continuación

• Los PCP aparecen                 posible que esos servicios          PCP antes de poder
  ordenados alfabéticamente        tengan que ser autorizados          tratarse con un especialista,
  en una de las siguientes         por su grupo de médicos de          excepto en el caso de la
  categorías: Medicina             la red.                             atención de la salud de
  Familiar, Medicina General,                                          rutina para la mujer, como
  Medicina Interna y             • Los centros de Atención             se describe abajo y en su
  Obstetricia/Ginecología. Su      Urgente afiliados a su grupo        Evidencia de Cobertura.
  PCP brindará o coordinará        de médicos están incluidos
  toda su atención médica          en la sección Centros de          2. Llame al consultorio del
  cubierta mientras usted sea      Atención Urgente. Usted             PCP que eligió para
  miembro de nuestro plan.         puede utilizar estos u otros        asegurarse de que él o ella
                                   Centros de Atención                 esté aceptando a pacientes
  Los PCP que no están             Urgente en el área de               nuevos de Blue Shield 65
  aceptando pacientes              servicio de Blue Shield 65          Plus (HMO) y para obtener
  nuevos se incluyen en la         Plus (HMO) si necesita              respuestas a cualquier
  categoría Solo se aceptan        atención médica urgente             pregunta que pueda surgir
  pacientes actuales. Usted        cuando el consultorio de su         sobre el médico (por
  solamente puede elegir un        PCP está cerrado.                   ejemplo, horarios de
  PCP en esta categoría si es                                          atención, disponibilidad por
  nuevo en Blue Shield 65        • Las farmacias del plan no           la tarde/noche y/o los fines
  Plus (HMO) y actualmente         figuran en este directorio.         de semana, y formación
  es paciente de dicho             Puede solicitar una lista de        académica).
  médico o si se cambia a un       estos centros llamando a
  nuevo grupo de médicos           nuestro Departamento de           3. Averigüe el número de
  del cual ese médico              Servicio para Miembros o            identificación del PCP que
  también forme parte.             ingresando en la sección            eligió e ingréselo en la
                                   Find a Provider (Encuentre          casilla correspondiente del
• Los especialistas afiliados      un Proveedor) de                    formulario de inscripción de
  aparecen ordenados               blueshieldca.com.                   Blue Shield 65 Plus (HMO).
  alfabéticamente según su
  especialidad. Si su PCP        Para elegir a su PCP, siga          Si necesita ayuda para elegir
  considera que usted             estos simples pasos:               un PCP, llámenos a uno de
  necesita más tratamiento                                           los números que figuran en la
  especializado, él o ella lo    1. De la lista de abajo, elija el   primera página de este
  derivará, con el                 médico que quiera como            directorio y solicite asistencia.
  consentimiento del grupo         PCP. Nota: si está
  de médicos, a un                 interesado en un                  Cambiar su PCP actual es
  especialista asociado con el     especialista en particular,        fácil
  grupo de médicos de la red.      asegúrese de que él o ella
                                   esté en el mismo grupo de         Usted puede cambiar de PCP
  Si su especialista le            médicos que el PCP que            en cualquier momento. Sin
  recomienda que continúe          usted eligió. Necesitará una      embargo, si está recibiendo
  con las visitas para seguir      derivación autorizada del         atención para pacientes
  con los tratamientos, es         grupo de médicos de su            internados en el hospital o se

xii
Cómo utilizar este directorio, continuación

encuentra en pleno                 Si usted es un miembro              circunstancias inusuales y
tratamiento con su PCP o           femenino que prefiere visitar       extraordinarias, la atención
especialista, le                   a un obstetra/ginecólogo para       se puede considerar como
recomendamos que no                someterse a atención de la          urgentemente necesaria
cambie de médico/grupo de          salud de rutina para la mujer       cuando el miembro se
médicos hasta que le den el        (mamografías, pruebas de            encuentra en el área de
alta o complete el tratamiento.    Papanicolau, y exámenes             servicio pero la red de
                                   ginecológicos y de mamas),          proveedores del Plan es
Si decide cambiar de PCP,          puede programar una cita con        inaccesible o no está
simplemente llame a Servicio       cualquier obstetra/ginecólogo       disponible temporalmente.
para Miembros y nos                que esté en la lista de su
aseguraremos de que el             grupo de médicos de la red sin    • Si necesita atención en un
médico que eligió esté             una derivación de su PCP.           caso de emergencia,
aceptando pacientes nuevos.                                            obtenga asistencia médica
Debería preguntar si el nuevo      Información importante              lo más pronto posible. Llame
PCP que eligió tiene una                                               al 911 para pedir ayuda o
relación de derivación con         • Si es posible, llame a su         diríjase a la sala de
alguno de los especialistas          PCP antes de solicitar            emergencias más cercana.
que usted visita actualmente.        atención médica. Si visita a      No necesita tener un
Nosotros haremos el cambio           un médico, hospital u otro        permiso previo de su médico
por usted, le avisaremos por         proveedor sin la aprobación       u otro proveedor de la red.
teléfono cuando se lleve a           de su PCP, usted será
cabo y le enviaremos una             responsable de los                Una emergencia médica es
nueva tarjeta de identificación      servicios. Ni Medicare            cuando usted considera que
de miembro.                          Original, ni Blue Shield 65       su salud corre un serio
                                     Plus (HMO) pagarán los            peligro, es decir, cuando
Si se comunica antes del día         servicios que no sean de          cada segundo cuenta. Una
15 del mes en curso, el              emergencia o la atención          emergencia médica incluye
cambio de PCP se hará                que no tenga carácter de          dolor intenso, una lesión
efectivo a partir del primer día     urgencia sin la autorización      seria, una enfermedad
del mes siguiente.                   previa de su PCP.                 grave o una afección
                                                                       médica que empeora
A veces, puede suceder que           La Atención Urgente hace          rápidamente.
un PCP, especialista o clínica       referencia a una situación
que le brinde atención deje el       sin carácter de emergencia        Asegúrese de que Blue
plan. De ser así, tendrá que         en la que usted está              Shield sepa sobre su
cambiarse a otro médico de la        temporalmente ausente del         emergencia, ya que será
red. Le notificaremos si ocurre      área de servicio autorizada       necesario que su médico
esto y nos aseguraremos de           del Plan, necesita atención       esté involucrado en el
que siga teniendo acceso a           médica inmediata para tratar      seguimiento de su atención
todos los servicios del paquete      una enfermedad, lesión o          de emergencia.
de beneficios de Blue Shield         afección imprevista y no es
65 Plus (HMO).                       razonable, dada la situación,     Usted u otra persona deben
                                     obtener atención médica a         llamar cuanto antes a su
                                     través de la red de               médico para notificarlo
                                     proveedores del Plan. En          acerca de su atención de

                                                                                                 xiii
Cómo utilizar este directorio, continuación

  emergencia, en lo posible          dicha atención recibida          unidades de cuidado
  dentro de las 48 horas. El         cumpla con la definición de      intensivo y 3) llevan a cabo
  número al que debe llamar          "atención urgentemente           procedimientos quirúrgicos
  se encuentra en su tarjeta         necesaria".                      de alto riesgo, como
  de identificación de                                                cirugías cardíacas, solo
  miembro de Blue Shield 65        • Algunos hospitales y             cuando se cumplen ciertos
  Plus (HMO).                        otros proveedores no             criterios de calidad.
                                     proporcionan uno o más
  ¿Qué ocurre si necesita            de los siguientes              • Si necesita servicios de
  atención médica                    servicios que pueden estar       enfermería especializada,
  inmediata en caso de               cubiertos en el contrato del     atención de transición o
  enfermedad o lesión                plan y que usted podría          servicios especializados,
  imprevista pero su salud           necesitar: planificación         su PCP coordinará su
  no corre serio peligro? Si         familiar; servicios de           transferencia a un centro de
  necesita asistencia médica         anticoncepción y                 atención subaguda que
  inmediata pero su salud no         esterilización, incluida la      tenga contrato con Blue
  corre grave peligro, dicha         ligadura de trompas              Shield u otro centro al cual
  asistencia se denomina             inmediatamente después           él o ella esté afiliado/a.
  "atención urgentemente             del parto. Para asegurarse       Puede solicitar una lista de
  necesaria". Si se encuentra        de que puede obtener los         estos centros llamando a
  en el área de servicio de su       servicios de atención de la      nuestro departamento de
  plan, llame a su PCP. Si el        salud que necesita, llame a      Servicio para Miembros.
  consultorio de su médico           nuestro departamento de
  está cerrado, diríjase al          Servicio para Miembros y       • Si recibe una factura de
  centro de atención urgente         solicite asistencia.             parte de cualquier
  que figura en la lista de este                                      proveedor no
  directorio.                      • Algunos hospitales               perteneciente a la red por
                                     participan en un                 servicios cubiertos, como
  Si se encuentra fuera del          programa de calidad              atención de emergencia o
  área de servicio, primero          independiente. Los               urgentemente necesaria, o
  llame a su PCP cuando sea          hospitales identificados con     servicios de diálisis renal
  posible. Si sufre una              el símbolo L participan en       fuera del área, no la pague.
  afección que requiere              el Leapfrog Group, un            En cambio, envíenos la
  atención de urgencia y             programa independiente de        factura a la siguiente
  recibe tratamiento mientras        California que trabaja para      dirección y nosotros
  está fuera del área de             implementar tres prácticas       abonaremos el monto
  servicio, preferimos que           esenciales que mejoran la        cubierto menos el/los
  regrese al área para recibir       seguridad del paciente,          monto/s de
  atención de seguimiento            según se ha demostrado.          copago/coseguro
  por parte de su PCP. No            Los hospitales Leapfrog: 1)      correspondiente/s:
  obstante, cubriremos la            controlan las recetas con
  atención de seguimiento            una computadora para             Blue Shield 65 Plus (HMO)
  que reciba de los                  evitar la interacción entre      Claims Department
  proveedores no                     medicamentos, 2) cuentan         P.O. Box 5014
  pertenecientes a la red que        con un médico especialista       Woodland Hills, CA
  estén fuera del área de            de tiempo completo en el         91365-9623
  servicio, siempre y cuando         personal de todas las

xiv
Arch Health Partners
Affiliated Hospitals              Carol C Cornelius, MD              Louis Maletz, MD
BlueSheidl65 PlusHMO

                                  ID No. U70007                      ID No. U70020
Palomar Medical Center L
                                  15611 Pomerado Rd STE 400          15611 Pomerado Rd STE 400
                                  PCPs -Fma il yPrcatice             PCPs-FamilyPractice

555 E Valley Pkwy
                                  Poway, CA 92064                    Poway, CA 92064
Escondido, CA 92025
                                  (858) 675-3210                     (858) 675-3170
Pomerado Hospital L               Languages: German and              Languages: Spanish
15615 Pomerado Rd                 Spanish
                                                                     Susan Meram, MD
Poway, CA 92064
                                  Charles L Hardison, MD             ID No. U70022
                                  ID No. U70073                      15611 Pomerado Rd STE 400
                                                                     PCPs-FamilyPractice

Urgent Care Centers               1236 Main St
                                  PCPs -Fma il yPrcatice

                                                                     Poway, CA 92064
Blue Shield 65 Plus HMO           Ramona, CA 92065                   (858) 675-3210
provides coverage for Urgent      (760) 789-5160                     Languages: Arabic
Care centers in network and       Languages: Russian
                                                                     Yusra A Mir
out of network. For an
                                  Janine Kasch, DO                   ID No. U70089
up-to-date list of Urgent Care
                                  ID No. U70012                      15611 Pomerado Rd STE 400
                                                                     PCPs-FamilyPractice

Centers in the network, please
                                  1236 Main Street                   Poway, CA 92064
                                  PCPs -Fma il yPrcatice

contact your medical group.
                                  Ramona, CA 92065                   (858) 675-3180
                                  (760) 789-5160                     Languages: Hindi and Urdu
Blue Shield 65 Plus HMO
                                  Languages: German and
brinda cobertura en los                                              Vivek C Nazareth, MD
                                  Spanish
centros de Atención Urgente                                          ID No. U70023
dentro y fuera de la red. Para    Cheng L Lee, MD                    15611 Pomerado Rd STE 400
                                                                     PCPs-FamilyPractice

obtener una lista actualizada     ID No. U70106                      Poway, CA 92064
de los Centros de Atención        120 Craven Rd STE 205              (858) 675-3210
                                  PCPs -Fma il yPrcatice

Urgente de la red,                San Marcos, CA 92078               Languages: Hindi
comuníquese con su grupo de       (790) 798-0088
médicos.                                                             Richard L Putman, MD
                                  Languages: Chinese and
                                                                     ID No. U70082
                                  Spanish
PCPs                                                                 15611 Pomerado Rd STE 400
                                                                     PCPs-FamilyPractice

                                  Christine E Lind, MD               Poway, CA 92064
Family Practice                   ID No. U70015                      (858) 675-3210
Ellen A Blando, MD                1236 Main St
                                  PCPs -Fma il yPrcatice

ID No. U70004                     Ramona, CA 92065                   Richard L Putnam, MD
1236 Main St
PCPs-Famiyl Pracitce

                                  (760) 789-5160                     ID No. U70026
                                                                     15611 Pomerado Road
                                                                     PCPs-FamilyPractice

Ramona, CA 92065                  Languages: French
(760) 789-5160                                                       STE 400
Languages: Tagalog                Gordon C Luan, MD                  Poway, CA 92064
                                  ID No. U70017                      (858) 675-3210
                                  1236 Main St
                                  PCPs -Fma il yPrcatice

                                  Ramona, CA 92065
                                  (760) 789-5160
                                  Languages: Chinese and
                                  Mandarin

L=LeapFrog
When you choose your PCP, you are also choosing the hospital(s) and specialty
network affiliated with the physician group.                                                 1
Arch Health Partners, continued
PCPs - Internal Medicine
Internal Medicine                         Specialty Physicians                            Donald L Ong, MD
                                                                                          Poway, CA
                                                                                          Specai tl yPhysci ans-EmergencyMedi cni e

David J Carty, MD                         Allergy & Immunology
ID No. U70006                                                                             Endocrinology
                                          Susan S Laubach, MD
15611 Pomerado Rd STE 400
PCPs-InetrnalMedci ne

                                          San Diego, CA                                   Timothy S Bailey, MD
                                          Specai l tyPhysic asn -Al ergy& mI munol gy

Poway, CA 92064
                                                                                          Escondido, CA
                                                                                          Specai tl yPhysci ans-Endocrinol gy

(858) 675-3293                            Maryam Zarei, MD
                                          Poway, CA                                       Susanna J Park, MD
                                          Specai l tyPhysic asn -Al ergy& mI munol gy

Belinda A Dure Smith, MD
                                                                                          San Diego, CA
                                                                                          Specai tl yPhysci ans-Endocrinol gy

ID No. U70008                             Audiology
15611 Pomerado Rd STE 400                                                                 Gastroenterology
PCPs-InetrnalMedci ne

                                          Debra J Abel, AuD
Poway, CA 92064
                                          Poway, CA                                       Ronald E Feldman, MD
                                          Specai l tyPhysic asn -Audoi l gy

(858) 675-3123
                                                                                          Escondido, CA
                                                                                          Specai tl yPhysci ans-Gatsorenterol gy

                                          Andrew Dickman, AuD
Dennis M Mamaril, MD
                                          Carlsbad, CA                                    Hyun S Kim, MD
                                          Specai l tyPhysic asn -Audoi l gy

ID No. U70021
                                                                                          Poway, CA
                                                                                          Specai tl yPhysci ans-Gatsorenterol gy

15611 Pomerado Rd STE 400                 Cardiology
PCPs-InetrnalMedci ne

Poway, CA 92064                                                                           Alan W Larson, MD
                                          Roger J Acheatel, MD
(858) 675-3123                                                                            Poway, CA
                                                                                          Specai tl yPhysci ans-Gatsorenterol gy

                                          Escondido, CA
                                          Specai l tyPhysic asn -Cadri ol gy

Larry A Presant, MD                                                                       Pritam Singh, MD
                                          Mikhail R Malek, MD
ID No. U70025                                                                             Escondido, CA
                                                                                          Specai tl yPhysci ans-Gatsorenterol gy

                                          Escondido, CA
                                          Specai l tyPhysic asn -Cadri ol gy

15611 Pomerado Rd STE 400
PCPs-InetrnalMedci ne

Poway, CA 92064                           Daniel F Mulvihill II, MD                       RICHARD J SNYDER, MD
                                                                                          Poway, CA
                                                                                          Specai tl yPhysci ans-Gatsorenterol gy

(858) 675-3123                            Poway, CA
                                          Specai l tyPhysic asn -Cadri ol gy

Kamen N Zakov, MD                         Rod D Serry, MD                                 Maram F Zakko, MD
                                                                                          Poway, CA
                                                                                          Specai tl yPhysci ans-Gatsorenterol gy

ID No. U70032                             Escondido, CA
                                          Specai l tyPhysic asn -Cadri ol gy

15611 Pomerado Rd STE 400
PCPs-InetrnalMedci ne

                                          Cardiovascular Disease                          General Surgery
Poway, CA 92064
(858) 675-3110                            Bill C Joswig, MD                               Edmond L Chan, MD
                                                                                          Poway, CA
                                                                                          Specai tl yPhysci ans-Geenral Surgery

Languages: Bulgarian                      Poway, CA
                                          Specai l tyPhysic asn -Cadri ovascularDisease

Robert P Zgliniec, MD                                                                     Franklin M Martin, MD
                                          Chiropractor
                                                                                          Escondido, CA
                                                                                          Specai tl yPhysci ans-Geenral Surgery

ID No. U70033
                                          Jay Dickson, DC
1236 Main St
PCPs-InetrnalMedci ne

                                          Poway, CA
                                          Specai l tyPhysic asn -Chri opractor
                                                                                          Stefan Moldovan, MD
Ramona, CA 92065                                                                          Escondido, CA
                                                                                          Specai tl yPhysci ans-Geenral Surgery

(760) 789-5160                            Dermatology
                                                                                          Geriatrics
Accepting Current                         Bryan K Chen, MD
                                          San Diego, CA
                                          Specai l tyPhysic asn -Dermaotl gy
                                                                                          Maria V Danilychev, MD
Patients Only                                                                             San Diego, CA
                                                                                          Specai tl yPhysci ans-Geairtrics

Bill C Joswig, MD
PCPs-Acceptni gCurentPatienst Onyl

                                          Stephen W Shewmake, MD
ID No. U70011                             Poway, CA
                                          Specai l tyPhysic asn -Dermaotl gy

                                                                                          Gynecology
15611 Pomerado Rd STE 400                                                                 Sutapa Ghosh, MD
PCPs-Acceptni gCurentPatienst Onyl

Poway, CA 92064                           Emergency Medicine
                                                                                          San Marcos, CA
                                                                                          Specai tl yPhysci ans-Gynecol gy

(858) 675-3100                            Lawrence A Koenig, MD
                                          Poway, CA
                                          Specai l tyPhysic asn -Emergency Medci ne

                                     Cuando elige a su PCP, también está eligiendo el/los hospital/es y la red de
2                                                                  especialistas afiliados al grupo de médicos.
Arch Health Partners, continued
                                                                                             Specialty Physicians - Hematology Oncology
Hematology Oncology                             Robert F Lasting, MD                                          Kevin C Owsley, MD
                                                Poway, CA                                                     Poway, CA
                                                Specai tl yPhysicans-Obstetrics/Gynecol gy                    Specai l tyPhysi cans-OrhtopedicSurgery

Alberto Bessudo, MD
Escondido, CA                                   Hanh M Le, MD                                                 Jeffrey S Schiffman, MD
Specai l tyPhysic ans -Hematol gyOncol gy

                                                San Diego, CA                                                 Escondido, CA
                                                Specai tl yPhysicans-Obstetrics/Gynecol gy                    Specai l tyPhysi cans-OrhtopedicSurgery

Edward P Huynh, MD
Poway, CA                                       Josue D Leon, MD                                              William Winternitz Jr, MD
Specai l tyPhysic ans -Hematol gyOncol gy

                                                Escondido, CA                                                 Poway, CA
                                                Specai tl yPhysicans-Obstetrics/Gynecol gy                    Specai l tyPhysi cans-OrhtopedicSurgery

Medical Oncology
John R Wilkinson, MD                            Nah Y Moon, MD                                                Otolaryngology
                                                Escondido, CA
                                                Specai tl yPhysicans-Obstetrics/Gynecol gy

San Diego, CA                                                                                                 Alison A Learn, MD
Specai l tyPhysic ans -Medci al Oncol gy

                                                Nicole J Nguyen, MD                                           Poway, CA
                                                                                                              Specai l tyPhysi cans-Otoal ryngol gy

Nephrology
                                                San Diego, CA
                                                Specai tl yPhysicans-Obstetrics/Gynecol gy

Joshua K Greenstein, MD                                                                                       Pain Management
Escondido, CA
Specai l tyPhysic ans -Nephrol goy

                                                Anuradha S Rode, MD                                           Timothy D Chong, MD
                                                Escondido, CA
                                                Specai tl yPhysicans-Obstetrics/Gynecol gy

                                                                                                              Poway, CA
                                                                                                              Specai l tyPhysi cans-Pani Management

Mark H Shapiro, MD
Escondido, CA
Specai l tyPhysic ans -Nephrol goy

                                                Ophthalmology                                                 Shafi M Khalid, MD
                                                Glenn B Cook, MD                                              Poway, CA
                                                                                                              Specai l tyPhysi cans-Pani Management

Neurology
                                                San Diego, CA
                                                Specai tl yPhysicans-Ophthaml ol ogy

Gilbert J Ho, MD                                                                                              Pathology
Poway, CA
Specai l tyPhysic ans -Neuorl ogy

                                                Russell P Edwards, MD                                         John B Campbell, MD
                                                San Diego, CA
                                                Specai tl yPhysicans-Ophthaml ol ogy

                                                                                                              San Diego, CA
                                                                                                              Specai l tyPhysi cans-Pahtol ogy

Michael S Rafii, MD
Poway, CA
Specai l tyPhysic ans -Neuorl ogy

                                                Jeffrey R Lozier, MD                                          Physical Med & Rehab
                                                Poway, CA
                                                Specai tl yPhysicans-Ophthaml ol ogy

Richard J Schumann, MD                                                                                        Keyvan Esmaeili, MD
San Diego, CA
Specai l tyPhysic ans -Neuorl ogy

                                                Optometry                                                     Escondido, CA
                                                                                                              Specai l tyPhysi cans-Physci aMel d& Rehab

Neurosurgery                                    Michelle Kim, OD                                              Plastic Surgery
                                                Poway, CA
                                                Specai tl yPhysicans-Optometry

Vrijesh S Tantuwaya, MD                                                                                       Antoine Hallak, MD
Poway, CA
Specai l tyPhysic ans -Neuorsuregry

                                                Orthopedic Surgery                                            San Diego, CA
                                                                                                              Specai l tyPhysi cans-Pal stci Surgery

Obstetrics/Gynecology                           Philip J Balikian, MD                                         Ralph E Holmes, MD
                                                Poway, CA
                                                Specai tl yPhysicans-Orthpoedi cSugrery

                                                                                                              San Diego, CA
                                                                                                              Specai l tyPhysi cans-Pal stci Surgery

Maria L Castillo, MD
Poway, CA
Specai l tyPhysic ans -Obste rics/Gyneocl ogy

                                                Brad Cohen, MD                                                Yale M Kadesky, MD
                                                Poway, CA
                                                Specai tl yPhysicans-Orthpoedi cSugrery

                                                                                                              Escondido, CA
                                                                                                              Specai l tyPhysi cans-Pal stci Surgery

Elizabth t Cerrone, DO
Escondido, CA
Specai l tyPhysic ans -Obste rics/Gyneocl ogy

                                                David L Daugherty, MD                                         Pulmonary Disease
                                                Oceanside, CA
                                                Specai tl yPhysicans-Orthpoedi cSugrery

Damon C Cobb, DO                                                                                              Frank Bender, MD
Encinitas, CA
Specai l tyPhysic ans -Obste rics/Gyneocl ogy

                                                Thomas R Knutson, MD                                          Escondido, CA
                                                                                                              Specai l tyPhysi cans-Puml oanryDisesae

                                                Escondido, CA
                                                Specai tl yPhysicans-Orthpoedi cSugrery

Ronald E Feldman, MD                                                                                          Gregory L Hirsch, MD
Escondido, CA
Specai l tyPhysic ans -Obste rics/Gyneocl ogy

                                                Laurence M McKinley, MD                                       Escondido, CA
                                                                                                              Specai l tyPhysi cans-Puml oanryDisesae

                                                Escondido, CA
                                                Specai tl yPhysicans-Orthpoedi cSugrery

Janet M Horenstein, MD                                                                                        Benjamin Kanter, MD
San Diego, CA
Specai l tyPhysic ans -Obste rics/Gyneocl ogy

                                                Payam Moazzaz, MD                                             Escondido, CA
                                                                                                              Specai l tyPhysi cans-Puml oanryDisesae

                                                Oceanside, CA
                                                Specai tl yPhysicans-Orthpoedi cSugrery

When you choose your PCP, you are also choosing the hospital(s) and specialty
network affiliated with the physician group.                                                                                                               3
Arch Health Partners, continued
Specialty Physicians - Pulmonary Disease
James Otoshi, MD
Escondido, CA
Speciatl yPhysci ans-Pul monary Dsi ease

Steven W Zgliniec, MD
Escondido, CA
Speciatl yPhysci ans-Pul monary Dsi ease

Rheumatology
Smitha C Reddy, MD
Poway, CA
Speciatl yPhysci ans-Rheumatol gy

Thoracic Surgery
Robert T Reichman, MD
Escondido, CA
Speciatl yPhysci ans-Thoraci Surgrey

Urology
Julian N Anthony, MD
Chula Vista, CA
Speciatl yPhysci ans-Urol gy

Evan M Vapnek, MD
San Diego, CA
Speciatl yPhysci ans-Urol gy

Vascular Surgery
Anatoly J Bulkin, MD
Escondido, CA
Speciatl yPhysci ans-VascularSuregry

Alexander C Salloum, MD
Escondido, CA
Speciatl yPhysci ans-VascularSuregry

Mental Health Providers
Psychology
JOANNE M HAMILTON
Poway, CA
Menatl Heal thProvdi ers-Psyhcol ogy

                                           Cuando elige a su PCP, también está eligiendo el/los hospital/es y la red de
4                                                                        especialistas afiliados al grupo de médicos.
San Diego Physicians Medical Group Central
Affiliated Hospitals              Truong M Hanh, MD                  Trung Tran, MD
                                  ID No. B40015                      ID No. B40014
Scripps Mercy Hospital San
                                  6905 Linda Vista Rd                4139 University Ave
                                  PCPs -Fma il yPrcatice             PCPs-FamilyPractice

Diego Campus L
                                  San Diego, CA 92111                San Diego, CA 92105
4077 Fifth Ave
                                  (858) 576-4416                     (619) 281-3443
San Diego, CA 92103
                                                                     Languages: French, Laotian
                                  Huong Nguyen, MD                   and Vietnamese
Urgent Care Centers               ID No. B40009
                                  4444 El Cajon Blvd STE 6           Duc Vo, MD
                                  PCPs -Fma il yPrcatice

Blue Shield 65 Plus HMO           San Diego, CA 92115                ID No. B40016
provides coverage for Urgent
                                  (619) 285-1522                     2418 Ulric St
                                                                     PCPs-FamilyPractice

Care centers in network and       Languages: Spanish and             San Diego, CA 92111
out of network. For an
                                  Vietnamese                         (858) 560-1226
up-to-date list of Urgent Care
                                                                     Languages: Spanish and
Centers in the network, please    Ngoc M Pham, MD
                                                                     Vietnamese
contact your medical group.       ID No. B40011
                                  2363 Urlic St STE B                General Practice
                                  PCPs -Fma il yPrcatice

Blue Shield 65 Plus HMO           San Diego, CA 92111                Barbara Denysiak, MD
brinda cobertura en los           (858) 268-1747
                                                                     ID No. B40005
centros de Atención Urgente       Languages: French and              3500 5th Ave STE 307
                                                                     PCPs-GeneralPractice

dentro y fuera de la red. Para    Vietnamese                         San Diego, CA 92103
obtener una lista actualizada
                                  David Ryan, MD                     (619) 294-6500
de los Centros de Atención
                                  ID No. B40012                      Languages: Polish
Urgente de la red,
                                  2931 Jarvis St
                                  PCPs -Fma il yPrcatice

comuníquese con su grupo de                                          Thu N Do, MD
médicos.                          San Diego, CA 92106                ID No. B40006
                                  (619) 222-2355                     4712 El Cajon Blvd STE F
                                                                     PCPs-GeneralPractice

PCPs                              Languages: Spanish                 San Diego, CA 92115
Family Practice                   Karen A Saroki, MD                 (619) 563-0724
                                  ID No. B40109                      Languages: French, Spanish
Taram M Dabo, MD
                                  550 Washington St STE 801
                                  PCPs -Fma il yPrcatice

                                                                     and Vietnamese
ID No. B40003
1919 Grand Ave STE 1E             San Diego, CA 92103
                                                                     Internal Medicine
PCPs-Famiyl Pracitce

San Diego, CA 92109               (619) 692-4401
                                  Languages: Spanish                 Gary De La Pena, MD
(858) 270-5454
                                                                     ID No. B40004
Languages: French and             Khang V Tran, MD                   4060 4th Ave STE 240
                                                                     PCPs-Itnenral Medi cne

Mandarin                          ID No. B40013                      San Diego, CA 92103
                                  6947 Linda Vista Rd STE A
                                  PCPs -Fma il yPrcatice

George Delgado, MD                                                   (619) 291-6064
ID No. B40107                     San Diego, CA 92111
550 Washington St STE 801
PCPs-Famiyl Pracitce
                                  (858) 569-8537
San Diego, CA 92103               Languages: French and
(619) 692-4401                    Vietnamese
Languages: Spanish

L=LeapFrog
When you choose your PCP, you are also choosing the hospital(s) and specialty
network affiliated with the physician group.                                                      5
San Diego Physicians Medical Group Central, continued
PCPs - Internal Medicine
Hiep T Nguyen, MD                                        Paul S Phillips, MD                             Enterology
ID No. B40008                                            San Diego, CA
                                                         Specai l tyPhysic asn -Cadri ol gy

                                                                                                         Rowley S Busino, MD
4419 Euclid Ave STE 105
PCPs-InetrnalMedci ne

                                                         Bobak Salami, MD                                La Mesa, CA
                                                                                                         Specai tl yPhysci ans-Enterol ogy

San Diego, CA 92115
                                                         San Diego, CA
                                                         Specai l tyPhysic asn -Cadri ol gy

(619) 582-2079                                                                                           Family Practice
Languages: French and                                    Cardiovascular Disease                          Thu N Do, MD
Vietnamese                                                                                               San Diego, CA
                                                         Richard G Friedman, MD
                                                                                                         Specai tl yPhysci ans-Famyli Practci e

Paul D Wagner, MD                                        San Diego, CA
                                                         Specai l tyPhysic asn -Cadri ovascularDisease

ID No. B40017
                                                                                                         Gastroenterology
                                                         Ali Salami, MD                                  Suja D Dubois, MD
4060 4th Ave STE 100
PCPs-InetrnalMedci ne

                                                         San Diego, CA
                                                         Specai l tyPhysic asn -Cadri ovascularDisease

San Diego, CA 92103                                                                                      San Diego, CA
                                                                                                         Specai tl yPhysci ans-Gatsorenterol gy

(619) 718-9444                                           Chiropractor                                    Robert M Epsten Jr, MD
Languages: Spanish
                                                         Kevin P Ryan, DC                                San Diego, CA
                                                                                                         Specai tl yPhysci ans-Gatsorenterol gy

                                                         San Diego, CA
                                                         Specai l tyPhysic asn -Chri opractor

Specialty Physicians                                                                                     Michael Goldhamer, MD
                                                         Colon & Rectal Surgery                          San Diego, CA
                                                                                                         Specai tl yPhysci ans-Gatsorenterol gy

Allergy & Immunology
                                                         Dennis E Mayer, MD                              Kevin S Haynes, MD
Alex J Mercandetti, MD
                                                         San Diego, CA                                   San Diego, CA
                                                         Specai l tyPhysic asn -Col n &Recatl Surgery    Specai tl yPhysci ans-Gatsorenterol gy

San Diego, CA
Speciatl yPhysci ans-Al ergy &Im nuol ogy

Jennifer Pendleton, MD                                   Dermatology                                     John Ponsiglione, MD
                                                                                                         San Diego, CA
                                                                                                         Specai tl yPhysci ans-Gatsorenterol gy

San Diego, CA
Speciatl yPhysci ans-Al ergy &Im nuol ogy

                                                         Bryan K Chen, MD
                                                         San Diego, CA                                   General Surgery
                                                         Specai l tyPhysic asn -Dermaotl gy

Bruce M Prenner, MD
San Diego, CA
Speciatl yPhysci ans-Al ergy &Im nuol ogy

                                                         Richard Kornberg, MD                            Choll W Kim, MD
                                                         San Diego, CA                                   San Diego, CA
                                                         Specai l tyPhysic asn -Dermaotl gy              Specai tl yPhysci ans-Geenral Surgery

Cardiac
Electrophysiology                                        Daniel J Marnell, MD                            Eugene W Rumsey Jr, MD
                                                         San Diego, CA                                   San Diego, CA
                                                         Specai l tyPhysic asn -Dermaotl gy              Specai tl yPhysci ans-Geenral Surgery

Brett J Berman, MD
San Diego, CA
Speciatl yPhysci ans-Cardai cEl ecrtohpysoi l ogy

                                                         Michelle T Pelle, MD                            Laurence K Tanaka, MD
                                                         San Diego, CA                                   San Diego, CA
                                                         Specai l tyPhysic asn -Dermaotl gy              Specai tl yPhysci ans-Geenral Surgery

Cardiology
                                                         Fred F Shahan, MD                               George Zorn III, MD
Nabil Dib, MD
                                                         San Diego, CA                                   San Diego, CA
                                                         Specai l tyPhysic asn -Dermaotl gy              Specai tl yPhysci ans-Geenral Surgery

San Diego, CA
Speciatl yPhysci ans-Cardoi l gy

Thomas E Diggs II, MD                                    Ear,nose,throat                                 Gynecology
San Diego, CA
Speciatl yPhysci ans-Cardoi l gy

                                                         Jeremiah J Moles, MD                            John B Seradj, MD
                                                         La Mesa, CA                                     Encinitas, CA
                                                         Specai l tyPhysic asn -Ea,rnoes,throat          Specai tl yPhysci ans-Gynecol gy

Jerrold Glassman, MD
San Diego, CA                                            Endocrinology                                   Gynecology Oncology
Speciatl yPhysci ans-Cardoi l gy

Shahin Keramati, MD                                      Brian P First, MD                               Sutapa Ghosh, MD
                                                         San Diego, CA                                   San Marcos, CA
                                                         Specai l tyPhysic asn -Endocrinol ogy           Specai tl yPhysci ans-Gynecol gy Oncol gy

San Diego, CA
Speciatl yPhysci ans-Cardoi l gy

Bruce J Kimura, MD                                       Jeffrey A Sandler, MD
                                                         San Diego, CA
                                                         Specai l tyPhysic asn -Endocrinol ogy

San Diego, CA
Speciatl yPhysci ans-Cardoi l gy

                                                    Cuando elige a su PCP, también está eligiendo el/los hospital/es y la red de
6                                                                                 especialistas afiliados al grupo de médicos.
San Diego Physicians Medical Group Central, continued
                                                                                               Specialty Physicians - Hematology Oncology
Hematology Oncology                               Frank Stella, MD                                              Oral Maxillofacial Surgery
                                                  La Mesa, CA
                                                  Specai tl yPhysicans-Nephrol gy

Robert M Barone, MD                                                                                             Bradley A Eli, DDS
San Diego, CA                                     Theodore S Thomas, MD                                         Encinitas, CA
Specai l tyPhysic ans -Hematol gyOncol gy                                                                       Specai l tyPhysi cans-OraMal xli ofacai l Surgery

                                                  San Diego, CA
                                                  Specai tl yPhysicans-Nephrol gy

Charles H Redfern, MD                                                                                           Lester Machado, MD
San Diego, CA                                     Jonathan Tiefenbrun, MD                                       San Diego, CA
Specai l tyPhysic ans -Hematol gyOncol gy                                                                       Specai l tyPhysi cans-OraMal xli ofacai l Surgery

                                                  San Diego, CA
                                                  Specai tl yPhysicans-Nephrol gy

Kristen N Rice, MD                                                                                              Orthopedic Surgery
San Diego, CA                                     Neurology
Specai l tyPhysic ans -Hematol gyOncol gy

                                                                                                                William S Adsit, MD
Alfred Saleh, MD                                  Boris Khamishon, MD                                           San Diego, CA
                                                                                                                Specai l tyPhysi cans-OrhtopedicSurgery

San Diego, CA                                     San Diego, CA
Specai l tyPhysic ans -Hematol gyOncol gy         Specai tl yPhysicans-Neurol gy

                                                                                                                Drew A Peterson, MD
Thomas A Shiftan, MD                              Jonathan Licht, MD                                            San Diego, CA
                                                                                                                Specai l tyPhysi cans-OrhtopedicSurgery

San Diego, CA                                     San Diego, CA
Specai l tyPhysic ans -Hematol gyOncol gy         Specai tl yPhysicans-Neurol gy

                                                                                                                Jeffery E Schultz, MD
Nephrology                                        Neurosurgery                                                  San Diego, CA
                                                                                                                Specai l tyPhysi cans-OrhtopedicSurgery

Jadwiga M Alexiewicz, MD                          Sohaib Kureshi, MD                                            Wesley R Smidt, MD
San Diego, CA                                     San Diego, CA                                                 San Diego, CA
Specai l tyPhysic ans -Nephrol goy                Specai tl yPhysicans-Neurosurgery                             Specai l tyPhysi cans-OrhtopedicSurgery

Joel J Baranski, MD                               Obstetrics/Gynecology                                         Otolaryngology
San Diego, CA
Specai l tyPhysic ans -Nephrol goy

                                                  Mylien V Ho, MD                                               Philip Azer, MD
Terry L Behrend, MD                               San Diego, CA                                                 San Diego, CA
                                                  Specai tl yPhysicans-Obstetrics/Gynecol gy                    Specai l tyPhysi cans-Otoal ryngol gy

San Diego, CA
Specai l tyPhysic ans -Nephrol goy

                                                  Tammy Pham, MD                                                Keith A Jackson, MD
Kenneth K Chung, MD                               San Diego, CA                                                 San Diego, CA
                                                  Specai tl yPhysicans-Obstetrics/Gynecol gy                    Specai l tyPhysi cans-Otoal ryngol gy

San Diego, CA
Specai l tyPhysic ans -Nephrol goy

                                                  Rifaat D Salem, MD                                            Carlos F Jimenez, MD
Luan K Do, MD                                     Torrance, CA                                                  Chula Vista, CA
                                                  Specai tl yPhysicans-Obstetrics/Gynecol gy                    Specai l tyPhysi cans-Otoal ryngol gy

San Diego, CA
Specai l tyPhysic ans -Nephrol goy

                                                  Alisa L Williams, MD                                          Michael J Rensink, MD
George Fadda, MD                                  San Diego, CA                                                 Chula Vista, CA
                                                  Specai tl yPhysicans-Obstetrics/Gynecol gy                    Specai l tyPhysi cans-Otoal ryngol gy

La Mesa, CA
Specai l tyPhysic ans -Nephrol goy

                                                  Michael C Wong, MD                                            John H Taylor, MD
Lucy M Miller, MD                                 San Diego, CA                                                 La Mesa, CA
                                                  Specai tl yPhysicans-Obstetrics/Gynecol gy                    Specai l tyPhysi cans-Otoal ryngol gy

San Diego, CA
Specai l tyPhysic ans -Nephrol goy

                                                  Oncology                                                      Pain Management
David S Namazi, MD                                Paul Goldfarb, MD                                             Douglas A Dobecki, MD
San Diego, CA
Specai l tyPhysic ans -Nephrol goy

                                                  San Diego, CA                                                 San Diego, CA
                                                  Specai tl yPhysicans-Oncol oyg                                Specai l tyPhysi cans-Pani Management

Bijal V Patel, MD                                 Ophthalmology                                                 Michael J Huntley, MD
San Diego, CA
Specai l tyPhysic ans -Nephrol goy

                                                                                                                San Diego, CA
                                                                                                                Specai l tyPhysi cans-Pani Management

                                                  Daniel Cotter, MD
Tagumpay E Sacamay, MD                            San Diego, CA
                                                  Specai tl yPhysicans-Ophthaml ol ogy

                                                                                                                David J Smith, MD
National City, CA
Specai l tyPhysic ans -Nephrol goy

                                                                                                                San Diego, CA
                                                                                                                Specai l tyPhysi cans-Pani Management

                                                  Barry Katzman, MD
Steven M Steinberg, MD                            San Diego, CA
                                                  Specai tl yPhysicans-Ophthaml ol ogy

                                                                                                                Plastic Surgery
San Diego, CA
Specai l tyPhysic ans -Nephrol goy

                                                  Sarjan H Patel, MD                                            Michael J Halls, MD
                                                  El Cajon, CA                                                  San Diego, CA
                                                  Specai tl yPhysicans-Ophthaml ol ogy                          Specai l tyPhysi cans-Pal stci Surgery

When you choose your PCP, you are also choosing the hospital(s) and specialty
network affiliated with the physician group.                                                                                                                        7
San Diego Physicians Medical Group Central, continued
Specialty Physicians - Plastic Surgery
Ralph E Holmes, MD                                     Smitha C Reddy, MD
San Diego, CA                                          Poway, CA
Speciatl yPhysci ans-Pl atsic Sugrery                  Specai l tyPhysic asn -Rheumatol ogy

Podiatry                                               Surgery
Hai T Tran, DPM                                        Paul Goldfarb, MD
San Diego, CA                                          San Diego, CA
Speciatl yPhysci ans-Podi atyr                         Specai l tyPhysic asn -Sugrery

Pulmonary Disease                                      Urology
Huan A Le, MD                                          Danny L Keiller, MD
San Diego, CA                                          San Diego, CA
Speciatl yPhysci ans-Pul monary Dsi ease               Specai l tyPhysic asn -Urlo gy

Julian P Lichter, MD                                   James L Robert, MD
San Diego, CA                                          San Diego, CA
Speciatl yPhysci ans-Pul monary Dsi ease               Specai l tyPhysic asn -Urlo gy

Joseph R Resnikoff, MD                                 Evan M Vapnek, MD
San Diego, CA                                          San Diego, CA
Speciatl yPhysci ans-Pul monary Dsi ease               Specai l tyPhysic asn -Urlo gy

Bradley Spitz, MD                                      Vascular Surgery
San Diego, CA
Speciatl yPhysci ans-Pul monary Dsi ease

                                                       Michael Sise, MD
Pulmonology                                            San Diego, CA
                                                       Specai l tyPhysic asn -Vasucl arSugrery

Steven C Wong, MD                                      Jack C Yang, MD
San Diego, CA                                          San Diego, CA
Speciatl yPhysci ans-Pul monol gy                      Specai l tyPhysic asn -Vasucl arSugrery

Reproductive
Endocrinology
Louis M Kettel, MD
San Diego, CA
Speciatl yPhysci ans-ReproductiveEndocrni ol gy

Rheumatology
Puja Chitkara, MD
San Diego, CA
Speciatl yPhysci ans-Rheumatol gy

Ara H Dikranian, MD
San Diego, CA
Speciatl yPhysci ans-Rheumatol gy

Oleg M Gavrilyuk, MD
San Diego, CA
Speciatl yPhysci ans-Rheumatol gy

Michael I Keller, MD
San Diego, CA
Speciatl yPhysci ans-Rheumatol gy

Katherine H Nguyen, MD
San Diego, CA
Speciatl yPhysci ans-Rheumatol gy

Mahmood Pazirandeh, MD
San Diego, CA
Speciatl yPhysci ans-Rheumatol gy

                                                  Cuando elige a su PCP, también está eligiendo el/los hospital/es y la red de
8                                                                               especialistas afiliados al grupo de médicos.
San Diego Physicians Medical Group Chula Vista
Affiliated Hospitals              Simona D Alb, MD                   Anne D Kaufhold, MD
                                  ID No. AS0205                      ID No. AS0242
Scripps Mercy Hospital
                                  480 4th Ave STE 202                3177 Oceanview Blvd
                                  PCPs -Fma il yPrcatice             PCPs-FamilyPractice

Chula Vista L
                                  Chula Vista, CA 91910              San Diego, CA 92113
435 H St
                                  (619) 427-3361                     (619) 231-9300
Chula Vista, CA 91910
                                  Languages: Romanian,               Languages: Spanish
Scripps Mercy Hospital San        Spanish and Tagalog
                                                                     Marianne A McKennett, MD
Diego Campus L
                                  Richard O Butcher, MD              ID No. AS0143
4077 Fifth Ave
                                  ID No. AS0137                      865 Third Ave STE 133
                                                                     PCPs-FamilyPractice

San Diego, CA 92103
                                  292 Euclid Ave STE 210             Chula Vista, CA 91910
                                  PCPs -Fma il yPrcatice

                                  San Diego, CA 92114                (619) 498-6200
Urgent Care Centers               (619) 263-6101                     Languages: Spanish
Blue Shield 65 Plus HMO           Marilyn Calderon, MD               Mayra Mendoza Dillon, MD
provides coverage for Urgent      ID No. AS0216                      ID No. AS0255
Care centers in network and       340 4th Ave STE 2                  1136 D Ave
                                  PCPs -Fma il yPrcatice             PCPs-FamilyPractice

out of network. For an            Chula Vista, CA 91910              National City, CA 91950
up-to-date list of Urgent Care    (619) 422-8338                     (619) 428-4463
Centers in the network, please    Languages: Spanish                 Languages: Spanish
contact your medical group.
                                  James E Cevallos, MD               William E Monk, MD
Blue Shield 65 Plus HMO           ID No. AS0244                      ID No. AS0005
brinda cobertura en los           4004 Beyer Blvd                    480 4th Ave STE 202
                                  PCPs -Fma il yPrcatice             PCPs-FamilyPractice

centros de Atención Urgente       San Ysidro, CA 92173               Chula Vista, CA 91910
dentro y fuera de la red. Para    (619) 428-4463                     (619) 427-3361
obtener una lista actualizada     Languages: Spanish
                                                                     Vanessa M Navarro, MD
de los Centros de Atención
                                  Gabriel Gil, MD                    ID No. AS0261
Urgente de la red,
                                  ID No. AS0138                      2400 East 8th St
                                                                     PCPs-FamilyPractice

comuníquese con su grupo de
                                  909 Cardiff St                     National City, CA 91950
                                  PCPs -Fma il yPrcatice

médicos.
                                  San Diego, CA 92114                (619) 428-4463
PCPs                              (619) 465-3121                     Languages: Tagalog
                                  Languages: Spanish
Family Practice                                                      Maria Oseguera, MD
Ovidiu Alb, MD                    David M Graham, MD                 ID No. AS0201
                                  ID No. AS0108                      2452 Fenton St STE 301
                                                                     PCPs-FamilyPractice

ID No. AS0199
                                  305 E 8th St                       Chula Vista, CA 91914
                                  PCPs -Fma il yPrcatice

480 4th Ave STE 202
PCPs-Famiyl Pracitce

Chula Vista, CA 91910             National City, CA 91950            (760) 946-4073
(619) 427-3361                    (619) 477-0084                     Languages: Serbian
Languages: Romanian,              Languages: Spanish
Spanish and Tagalog

L=LeapFrog
When you choose your PCP, you are also choosing the hospital(s) and specialty
network affiliated with the physician group.                                                    9
San Diego Physicians Medical Group Chula Vista, continued
PCPs - Family Practice
Clara L Polak, MD             John R Swartz, MD                    David M Graham, MD
ID No. AS0144                 ID No. AS0147                        ID No. AS0108
480 4th Ave STE 202           1637 3rd Ave                         305 E 8th St
PCPs-Famyli Practci e         PCPs-Famiyl Pracitce                 PCPs -General Prcatice

Chula Vista, CA 91910         Chula Vista, CA 91911                National City, CA 91950
(619) 427-3361                (619) 205-1360                       (619) 477-0084
Languages: Spanish            Languages: Spanish                   Languages: Spanish
Jean A Rizkallah, MD          Nii A Tetteh, MD                     Internal Medicine
ID No. AS0145                 ID No. AS0149                        Valerie C Altavas, MD
450 4th Ave STE 408           502 S Euclid Ave STE 204
PCPs-Famyli Practci e         PCPs-Famiyl Pracitce

                                                                   ID No. AS0135
Chula Vista, CA 91910         National City, CA 91950
                                                                   655 Euclid Ave STE 209
                                                                   PCPs -nIternal Medci ne

(619) 691-1990                (760) 434-7284
                                                                   National City, CA 91950
Languages: French and         Languages: Spanish
                                                                   (619) 470-7000
Spanish
                              Abel C Toledo, MD                    Languages: Spanish and
Anna Roytman, MD              ID No. AS0241                        Tagalog
ID No. AS0210                 330 Oxford St STE 110
                              PCPs-Famiyl Pracitce

                                                                   John J Duque, MD
1620 Alpine Blvd              Chula Vista, CA 91911
PCPs-Famyli Practci e

                                                                   ID No. AS0011
Alpine, CA 91901              (619) 427-7181                       480 4th Ave STE 316
                                                                   PCPs -nIternal Medci ne

(619) 445-6200                Languages: Spanish                   Chula Vista, CA 91910
Languages: Russian                                                 (619) 691-0240
                              Raul Trejo, MD
Edward W Schumaker, MD        ID No. AS0151                        Languages: Spanish
ID No. AS0202                 865 3rd Ave STE 133
                              PCPs-Famiyl Pracitce

                                                                   Rocio M Flores, MD
2452 Fenton St STE 301        Chula Vista, CA 91911
PCPs-Famyli Practci e

                                                                   ID No. AS0249
Chula Vista, CA 91914         (619) 498-6200                       480 Fourth Ave STE 516
                                                                   PCPs -nIternal Medci ne

(760) 949-4073                Languages: Spanish                   Chula Vista, CA 91910
Languages: Spanish
                              Maria G                              (619) 476-9054
Shaila Serpas, MD             Trimor-Tamoria, MD                   Languages: Spanish
ID No. AS0146                 ID No. AS0195                        Alejandro G
865 Third Ave STE 133         2240 E Plaza Blvd STE A
PCPs-Famyli Practci e         PCPs-Famiyl Pracitce

                                                                   Hinojosa-Valencia, MD
Chula Vista, CA 91910         National City, CA 91950              ID No. AS0140
(619) 498-6200                (619) 267-5884                       340 4th Ave STE 10
                                                                   PCPs -nIternal Medci ne

Languages: Spanish            Languages: Spanish and               Chula Vista, CA 91910
                              Tagalog                              (619) 216-7546
Edward J Sheldon, MD
ID No. AS0243                 General Practice                     Languages: Spanish
909 Cardiff St
PCPs-Famyli Practci e

                              Monica P Cepin, MD                   Mushrik Kaisey, MD
San Diego, CA 92114           ID No. AS0230                        ID No. AS0209
(619) 465-3121                480 4th Ave STE 507                  340 4th Ave STE 9
                              PCPs-GeneralPracitce                 PCPs -nIternal Medci ne

Languages: Spanish            Chula Vista, CA 91910                Chula Vista, CA 91910
                              (619) 427-0665                       (619) 426-9731
                              Languages: French and                Languages: Arabic and
                              Spanish                              Spanish

                         Cuando elige a su PCP, también está eligiendo el/los hospital/es y la red de
10                                                     especialistas afiliados al grupo de médicos.
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