Dap Health, Inc.
Organization Active NPI Federally Qualified Health Center (FQHC) · El Cajon, CA
NPI 1154480069 · NPPES record last updated Mar 7, 2024
Key facts
- NPI
- 1154480069
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- DAP HEALTH, INC.
- Practice address
- 133 W Main St
El Cajon, CA 92020-3315 - Phone
- (619) 401-0404
- NPI assigned
- Dec 6, 2006
- Organization subpart
- No
Authorized official
- Name
- Judy Stith
- Title
- Chief Administrative Officer
- Phone
- (760) 323-2118
Other NPIs on the same Medicare enrollment 14
Other NPIs with the same Medicare PAC ID 14
Practitioners 69
-
Silas Gyimah, M.D
-
David Houston Morris, M.D.
-
Rhett Papa, D.O.
-
Damoun A Rezai, M.D., M.H.A.
-
Sylvia Akua Searleman, MSN, AGNP-C
-
Noori Noori, MD
-
Marlyne Abon, NURSE PRACTITIONER
-
Kenneth Tembei Acha, M.D.
-
Karrar H. Ali, D.O.
-
Joseph Aquilina, MD
-
Muhammad Arif, MD
-
Clayton O Barbour II, M.D.
-
Emma Bermudez, NP
-
Flordeliza Medina Burns, P.A.-C.
-
Felipe Mendez Cendejas, PA-C
-
Joseph George Cerjan, M.D.
-
Vache Chakmakian, M.D.
-
Lorraine Y Chun, M.D.
-
Lyle Cook, PA
-
William E Daniel, APRN, MSN, FNP-BC
-
Monica Diaz, FNP-C
-
Robert Fontanilla, PA-C
-
Dauod Ghafari, MD
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D0915458 | Dap Health - Centro Medico El Cajon | Certificate of waiver | Jun 14, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CA
Federally qualified health center certification: CCN 051095
- Legal name
- DAP HEALTH INC
- Doing business as
- DAP HEALTH-CENTRO MEDICO EL CAJON
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Jun 14, 2007
- Last certification
- Jun 14, 2007
- Ownership / control type
- For profit – corporation
- Most recent change of ownership
- Jul 1, 2023 (1 total)
- Organization structure
- Corporation · Non-profit
- Incorporated
- Aug 22, 1984 in CA
- Enrollment address
- 133 W Main St
El Cajon, CA 92020-3315
All disclosed owners & managing parties 16
| Name | Role | Since | Share |
|---|---|---|---|
| David Brinkman |
Corporate Officer |
Aug 1, 2023 | 100% |
| Patrick Jordan |
Corporate Director |
Aug 1, 2023 | |
| Frederick Drewette |
Corporate Director |
Aug 1, 2023 | |
| Gladis Adriana Perez |
W-2 Managing Employee |
Aug 1, 2023 | |
| Veronica Willimas |
Corporate Director |
Feb 27, 2024 | |
| Judy Stith |
Corporate Officer |
Aug 1, 2023 | |
| Athalie Lapamuk |
Corporate Director |
Aug 1, 2023 | |
| Scot Karp |
Corporate Director |
Jun 1, 2024 | |
| Mark Charles Adams |
Corporate Director |
Jun 1, 2024 | |
| Kevin Bass |
Corporate Director |
Aug 1, 2023 | |
| Carolyn Caldwell |
Corporate Director |
Aug 1, 2023 | |
| Bruce Finch |
Corporate Director |
Aug 1, 2023 | |
| Karyl Ketchum |
Corporate Director |
Aug 1, 2023 | |
| Frank Figueroa |
Corporate Director |
Aug 1, 2023 | |
| Eve Fromberg |
Corporate Director |
Aug 1, 2023 | |
| Mark Hamilton |
Corporate Director |
Aug 1, 2023 |
Change-of-ownership history
| Date | Event | Counterparty |
|---|---|---|
| Jul 31, 2023 | Change of Ownership |
Centro Medico, El Cajon |
| Jul 31, 2023 | Change of Ownership |
Dap Health-Centro Medico El Cajon |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100608000193 | CA | Part B Supplier - Clinic/Group Practice | 6002989522 |
Receives reassigned benefits from 103 practitioners 16 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Thermal, CA; San Jacinto, CA; Cathedral City, CA; Palm Springs, CA; Escondido, CA; El Cajon, CA; Desert Hot Springs, CA; Coachella, CA… |
| O20240401002689 | CA | Part a Provider - Federally Qualified Health Center (FQHC) | 6002989522 | Practice locations: El Cajon, CA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | CA | ||
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
133 W Main St
El Cajon, CA 92020-3315
Mailing address
1695 N. Sunrise Way
Palm Springs, CA 92262
Phone (760) 323-2118
Other names
- DAP Health-Centro Medico El Cajon
Other providers in El Cajon, CA
- Ebony Sherelle Daniels
- Jannashaa Daniels
- Danmat Corporation
- Danny Truong DDS, a Professional Corporation
- Amanda Daoud
- Sarah Darwich
- Mariam S Darzi
- Sohini Das
- Roberto Datiles
- Aditya Datta
All providers in El Cajon, CA · Federally Qualified Health Center (FQHC) in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.