Cedar Health and Wellness EPO Plan Participating EPO Provider Listing

Transcription

1 Cedar Health and Wellness EPO Plan Participating EPO Provider Listing Fitch Street Irvine CA CUSTOMER SERVICE: Address:

2 WESTERN GROWERS ASSURANCE TRUST PARTICIPATING PROVIDER LISTING INTRODUCTION We are pleased to make the Western Growers Assurance Trust (WGAT) Participating Provider Listing available to you. This listing indicates participating providers in the geographic area(s) indicated on the front cover. Please keep this list in a convenient place for easy reference. WGAT makes available a supplemental network of providers that offer quality health care at a reasonable cost. These WGAT Participating Providers have agreed to provide services at rates that are usually much lower than their normal charges. This can help you reduce the cost of medical care for both you and your health plan. All WGAT providers are listed alphabetically by physician last name in order by specialty within each state and respective county. The providers listed in this directory are solely responsible for the quality and course of medical treatment. They are affiliated with WGAT only as independent contractors and not as employees. The health care providers listed in this directory are current as of the date printed at the bottom of each page. It is your responsibility to verify with the provider at the time of treatment that the provider is still participating with WGAT in the Cedar EPO plan. This listing indicates providers with which WGAT contracts in the indicated geographic area. Your plan of benefits may not include coverage for all types of providers and/or all services provided by the WGAT Participating Provider. Please check your Summary Plan Description (SPD) for a complete description of your coverage, limitations and/or exclusions or contact the WGAT Customer Service department. Customer Service Department: If your plan requires pre-authorization by the Utilization Review department, please follow the instructions in your SPD on how to do this. If you need to inquire about a future admission or need to notify the Utilization Management (UM) department of a current admission to the hospital, please call UM Monday through Friday 7:00 a.m. to 4:30 p.m. at: Utilization Management: Fitch Street Irvine CA CUSTOMER SERVICE: Address: CustomerService@wga.com

3 INTRODUCCIÓN DE LA RED DE PROVEEDORES PARTICIPANTES DEL SEGURO DEL FIEDEICOMISO DE WESTERN GROWERS ASSURANCE TRUST Es un placer poner a su disposición la Red de Proveedores Participantes de Western Growers Assurance Trust (WGAT). En este directorio esta la lista de los proveedores participantes en el área geografica que se indica en la parte superior de cada página. Por favor tengala a la mano para consultarla cuando necesite. WGAT le da acceso a una red de proveedores que ofrecen atención medica de calidad a precio razonable. Estos Proveedores Participantes de WGAT han acordado servirle a usted por tarifas que por lo regular son más bajas que lo que ellos cobran normalmente. De está manera WGAT ayuda a reducir el costo de la atención medica para usted y para su plan medico. Todos los Proveedores de WGAT están impresos por condado y en orden por especialidad. Los proveedores impresos en este directorio son los únicos responsables por la calidad y el curso del tratamiento medico y están afiliados con WGAT sólo como contratistas independientes y no como empleados. Los proveedores impresos en este directorio están actualizados a la fecha impresa en la parta superior de cada página. Continuamente se están añadiendo proveedores nuevos y de vez en cuando algun proveedor deja de participar en nuestra red. Por lo tanto, debe usted consultar con el médico, el hospital, el dentista, o cualquier otro proveedor al obtener tratamiento para verificar su participación en la red. También puede ponerse en contacto con nuestro departamento de servicio al cliente al: Departamento de Servicio al Cliente: En este directorio se encuentran todos los proveedores con los cuales WGAT tiene contrato en este área. Posiblemente su plan de beneficios no incluya cobertura para todos los tipos de proveedores y/o todos los servicios disponibles por medio de los proveedores de WGAT. Por favor consulte su Descripción Sumaria del Plan para la descripción de su cobertura, limitaciónes y/o exclusiónes. Por favor revise si su plan requiere Revisión de Utilización (UR). Si su plan requiere UR, por favor siga los requisitos especificados en su Descripción Sumaria del Plan. Si necesita preguntar tocante a un internamiento en el futuro o si necesita notificar al departamento de UR de un internamiento actual, puede usted llamar al departamento de UR de lunes a viernes de las 7:00 am a 4:30 pm a: Revisión de Utilización: Fitch Street Irvine CA CUSTOMER SERVICE: Address: CustomerService@wga.com

4 ARIZONA Western Growers Assurance Trust Designated PCP Participating Providers YUMA COUNTY Hospital Services Urgent Care Services Yuma Regional Medical Center 2400 S. Avenue A 2060 W. 24th St. Yuma, AZ Yuma, AZ Designated Primary Care/Cedar Centers 2060 W. 24th St. Yuma, AZ of 18 Cedar EPO List - rev

5 Western Growers Assurance Trust Designated PCP Participating Providers CALIFORNIA FRESNO COUNTY Urgent Care Services Use one of the Clinica Sierra Vista Care centers listed below Designated Primary Care/Cedar Centers Clinica Sierra Vista - Divisadero Designated Primary Care/Cedar Centers Clinica Sierra Vista - Regional 145 N. Clark 2505 Divisadero St. Fresno, CA Fresno, CA Clinica Sierra Vista - Easton 5784 S. Elm Ave. Clinica Sierra Vista - W. Fresno 302 Fresno St., Ste. 101 Fresno, CA Fresno, CA Clinica Sierra Vista - Elm Community 2740 S. Elm Ave. Clinica Sierra Vista - W. Shaw Community 4739 W. Shaw Ave., Ste. 108 Fresno, CA Fresno, CA Clinica Sierra Vista - Elm Women's & Pediatric 2760 S. Elm Ave. Clinica Sierra Vista-North Fine Community 1945 N. Fine, Ste. 100 Fresno, CA Fresno, CA Clinica Sierra Vista - Garland 3727 N First St., Ste 106 Fresno, CA Clinica Sierra Vista - Orange & Butler 1350 S. Orange Ave Fresno, CA IMPERIAL COUNTY X Ray Valley Endoscopy Center 1550 N. Imperial Ave, Ste 3 El Centro, CA of 18 Cedar EPO List - rev

6 Western Growers Assurance Trust Designated PCP Participating Providers KERN COUNTY Hospital Services Urgent Care Services Bakersfield Memorial Hospital Use one of the Clinica Sierra Vista Care centers listed below th St Bakersfield, CA (661) Physician's Automated oratory 2801 H Street Bakersfield, CA Designated Primary Care/Cedar Centers Bakersfield Family Medical Center 4580 California Ave. Bakersfield, CA Designated Primary Care/Cedar Centers Clinica Sierra Vista - 34th St. Clinica Sierra Vista-Arvin Community Health 2000 Physician's Plaza 1305 Bear Mountain Blvd. Bakersfield, CA Arvin, CA Clinica Sierra Vista - Bakersfield College Clinica Sierra Vista-Death Valley Health Ctr 181 Panorama Dr. Old Highway 127 Bakersfield, CA Shoshone, CA Clinica Sierra Vista - Central Bakersfield Clinica Sierra Vista-Delano Community 301 Brundage Ln Garces Hwy. Bakersfield, CA Delano, CA Clinica Sierra Vista - E. Bakersfield Clinica Sierra Vista-Frazier Mountain 815 Dr. Martin Luther King Jr. Blvd. 704 Lebec Road Bakersfield, CA Lebec, CA Clinica Sierra Vista - Family Health Ctr. Clinica Sierra Vista-Greenfield Community st St South H St. Bakersfield, CA Bakersfield, CA Clinica Sierra Vista - North of River Clinica Sierra Vista-Kern River Health Ctr 2525 N. Chester Ave. 67 Evans Rd. Bakersfield, CA Wofford Heights, CA Clinica Sierra Vista - Old Town Clinica Sierra Vista-Kern Valley Med. Ctr 234 Baker St., Ste. 1 & Lake Isabella Blvd. Bakersfield, CA Lake Isabella, CA Clinica Sierra Vista - S. Bakersfield Clinica Sierra Vista-Lamont Community 2400 Wible Rd., Ste Hall Rd. Bakersfield, CA Lamont, CA Clinica Sierra Vista-Arvin Community Health Clinica Sierra Vista-McFarland Community 1305 Bear Mountain Blvd. 217 West Kern Ave. Arvin, CA McFarland, CA of 18 Cedar EPO List - rev

7 Western Growers Assurance Trust Designated PCP Participating Providers LOS ANGELES COUNTY Surgery Center Surgicenter of South Bay Madison Street Torrance, CA X Ray Designated Primary Care/Cedar Centers Huntington MRI AltaMed Medical Group - Estrada Courts 10 Pico 1305 S. Concord St., Ste. 18 Pasadena, CA Los Angeles, CA Designated Primary Care/Cedar Centers AltaMed Medical Group - Montebello AltaMed Medical & Dental Group - Bell 2321 W. Whittier Blvd S. Atlantic Ave. Montebello, CA Bell, CA AltaMed Medical Group - Pico Rivera AltaMed Medical & Dental Group - El Monte 9436 E. Slauson Ave Valley Blvd., Ste. B Pico Rivera, CA El Monte, CA AltaMed Medical Group - Ramona Gardens AltaMed Medical Group - 1st St Crusado Ln., Ste E. 1st St. Los Angeles, CA Los Angeles, CA AltaMed Medical Group - William Mead AltaMed Medical Group - Boyle Heights 268 Bloom St., Ste Whittier Blvd. Los Angeles, CA Los Angeles, CA AltaMed Medical Group - Buena Care 1701 Zonal Ave. Los Angeles, CA AltaMed Medical Group - Commerce 5427 E. Whittier Blvd. Los Angeles, CA MERCED COUNTY Hospital Services Mercy Medical Center Merced 333 Mercy Ave Merced, CA (209) of 18 Cedar EPO List - rev

8 Western Growers Assurance Trust Designated PCP Participating Providers MONTEREY COUNTY Hospital Services Urgent Care Services Natividad Medical Center Cedar Health & Wellness Center 1441 Constitution Blvd. 955 Blanco Circle Salinas, CA Salinas, CA X Ray Clinica de Salud Coastal Valley Imaging 799 Front St. 626 Brunken Ave. Soledad, CA Salinas, CA Clinica de Salud Coastal Valley Imaging Center of Carmel 808 Oak Ave Carmel Rancho Blvd. Greenfield, CA Carmel, CA Salinas Valley Radiologists 559 Abbott St. Salinas, CA Valle Verde Imaging Center 1326 Natividad Rd., Ste. E Salinas, CA Designated Primary Care/Cedar Centers Designated Primary Care/Cedar Centers Cedar Health & Wellness Center Clinica de Salud 955 Blanco Circle 799 Front St. Salinas, CA Soledad, CA Clinica de Salud 808 Oak Ave. Greenfield, CA RIVERSIDE COUNTY Surgery Center Riverside Medical Center Surgery Center 7160 Brockton Ave Riverside, CA SACRAMENTO COUNTY Hospital Services Mercy General Hospital 4001 J Street Sacramento, CA (916) of 18 Cedar EPO List - rev

9 Western Growers Assurance Trust Designated PCP Participating Providers SAN JOAQUIN COUNTY Hospital Services St. Joseph's Medical Center of Stockton 1800 N. California St Stockton, CA (209) SAN LUIS OBISPO COUNTY Hospital Services St. Joseph's Medical Center of Stockton Physician's Automated oratory 1800 N. California St 3701 S. Higuera St. Stockton, CA San Luis Obispo, CA (209) SANTA BARBARA COUNTY Hospital Services Urgent Care Services Marian Regional Medical Center Cedar Health & Wellness Center 1400 E. Church St 1414 S. Miller St., Ste. P Santa Maria, CA Santa Maria, CA (805) open until 7pm Wednesday Surgery Center Santa Maria Ambulatory Surgery & Laser Center 120 N. Miller St, Ste C Physician's Automated oratory Santa Maria, CA Calle Real Goleta, CA Designated Primary Care/Cedar Centers Cedar Health & Wellness Center 1414 S. Miller St., Ste. P Santa Maria, CA SANTA CRUZ COUNTY Hospital Services Watsonville Community Hospital 75 Nielson St. Watsonville, CA Dominican Hospital 1555 Soquel Dr Santa Cruz, CA (831) of 18 Cedar EPO List - rev

10 Western Growers Assurance Trust Designated PCP Participating Providers STANISLAUS COUNTY Urgent Care Services Turlock Urgent Care 2010 Colorado Ave. Turlock, CA (209) VENTURA COUNTY Hospital Services Urgent Care Services St. John's Regional Medical Center 1600 N. Rose Ave 3291 Loma Vista Rd. Oxnard, CA Ventura, CA (805) X Ray Grossman Medical Imaging 2001 N. Solar Dr., Ste Oxnard, CA Anita Bajaj, MD 825 N. Tenth St Santa Paula, CA (805) Bruce Matthews, MD 3291 Loma Vista Rd Ventura, CA (805) Matthew Carr, MD 3291 Loma Vista Rd Ventura, CA (805) Designated Primary Care/Cedar Centers 3291 Loma Vista Rd. Ventura, CA of 18 Cedar EPO List - rev

11 Wesstern Growers Assurance Trust ARIZONA YUMA COUNTY Family Practice Internal Medicine Internal Medicine Pediatrics Yuma IPA Yuma IPA Steven Anderson, MD Engida Alemu, MD Ching Wang, MD Raymond Hatton, MD 2140 W. 24th St, Ste B 2281 W. 24th St., Ste W. 24th St W. 24th St. Yuma, AZ Yuma, AZ Yuma, AZ Yuma, AZ (928) Yuma Valley Family Medicine Center - Yuma IPA Yuma IPA Kristina Diaz, MD Moe Aung, MD Dorothy Wong, MD Kanka Karmakar, MD 2270 S. Ridgeview Dr, Ste W. 24th St W. 24th St, Ste W. 24th St. Yuma, AZ Yuma, AZ Yuma, AZ Yuma, AZ (928) (928) Yuma Infusion Center - Yuma IPA Pediatrics Wilbur Don Duque, MD Clarence Clark, MD Yuma Community Physicians - Yuma IPA Denise Marshall, NP 2060 W. 24th St S. Ridgeview Drive, Suite 128 Saad Alou, MD 815 E. Juan Sanchez Blvd. Yuma, AZ Yuma, AZ S. Ridgeview Dr, Ste 201 San Luis, AZ (928) Yuma, AZ (928) Yuma IPA Yuma Infusion Center - Yuma IPA Mitch Freeman, MD Clarence Clark, MD Yuma Community Physicians - Yuma IPA Denise Marshall, NP 2120 W. 24th St, Ste B 2270 S. Ridgeview Drive, Suite 130 Saad Alou, MD 115 N. Somerton Ave. Yuma, AZ Yuma, AZ S. Avenue A, Ste A Somerton, AZ (928) (928) Yuma, AZ (928) Yuma Community Physicians - Yuma IPA Roberto Garcia, MD Syed Hussain, MD Yuma Pediatrics - Yuma IPA Denise Marshall, NP 2435 S. Avenue A, Ste A 2060 W. 24th St. Jean Amon, MD 2060 W. 24th St. Yuma, AZ Yuma, AZ nd Drive, Suite 2 Yuma, AZ (928) Yuma, AZ (928) Yuma Community Physicians - Yuma IPA Yuma IPA Roberto Garcia, MD Renu Magu, MD Emilia Matos, MD 1150 W. 24th St, Ste C 2060 W. 24th St. Mwela Asombang, MD 1073 W. 23rd Street Yuma, AZ Yuma, AZ N. Somerton Ave. Yuma, AZ (928) Somerton, AZ (928) Yuma Community Physicians - Yuma IPA Yuma IPA Yuma IPA Roberto Garcia, MD Christopher Moor, MD Patti Perry, MD 2295 S. Elks Lane 1881 W. 24th Street, Suite B Mwela Asombang, MD 1832 S. 8th Ave Yuma, AZ Yuma, AZ E. Juan Sanchez Blvd. Yuma, AZ (928) (928) San Luis, AZ (928) Yuma IPA Arizona Medical Center - Yuma IPA Yuma Pediatrics - Yuma IPA John Gietzen, DO Manjunath Nathan, MD Cynthia Sison, MD 2270 S. Ridgeview Dr, Ste W. 24th St, Ste A Mwela Asombang, MD nd Drive, Suite 2 Yuma, AZ Yuma, AZ W. 24th St. Yuma, AZ (928) (928) Yuma, AZ (928) Yuma Community Physicians - Yuma IPA Advanced Medical Clinic - Yuma IPA Ismael Guerrero, MD Loc Nguyen, MD Saika Somjee, MD 1965 W. 24th St, Ste A 1001 W. 17th Street Kishor Bhende, MD 2060 W. 24th St. Yuma, AZ Yuma, AZ E. Juan Sanchez Blvd. Yuma, AZ (928) (928) San Luis, AZ Yuma Community Physicians - Yuma IPA Ismael Guerrero, MD Prabodh Rathi, MD Women's Health Specialists of Yuma 2435 S. Avenue A, Ste A 815 E. Juan Sanchez Blvd. Kishor Bhende, MD J. Brock Amon, MD Yuma, AZ San Luis, AZ N. Somerton Ave S. 8th Ave. (928) Somerton, AZ Yuma, AZ Yuma Valley Family Medicine Center - Yuma IPA Ricky Ochoa, MD Prabodh Rathi, MD Women's Health Specialists of Yuma 2270 S. Ridgeview Dr, Ste N. Somerton Ave. Kishor Bhende, MD Robert Barnett, MD Yuma, AZ Somerton, AZ W. 24th St S. 8th Ave. (928) Yuma, AZ Yuma, AZ Yuma Primary Care - Yuma IPA Hazem Shehata, MD Prabodh Rathi, MD Yuma Pediatrics - Yuma IPA Women's Health Specialists of Yuma 2450 S. 4th Ave, Ste W. 24th St. Daniel Crawford, MD Julie Dance, NMW Yuma, AZ Yuma, AZ nd Drive, Suite S. 8th Ave. (928) Yuma, AZ Yuma, AZ (928) Sathya Vemuri, MD Oliver Severino, MD Yuma Pediatrics - Yuma IPA Women's Health Specialists of Yuma 2060 W. 24th St W. 24th St. Gowan Deckey, MD Bryan Freeman, MD Yuma, AZ Yuma, AZ nd Drive, Suite S. 8th Ave Yuma, AZ Yuma, AZ (928) * Use of the Participating Providers on the following pages are part of your plan, but may require a higher copayment than the use of the Designaed Participating PCP Providers Eff 1/1/2014_rev1_ Page 8 of 18

12 Wesstern Growers Assurance Trust ARIZONA YUMA COUNTY Women's Health Specialists of Yuma Maria Gasca-Holtz, MD Raja Mittapalli, MD 2911 S. 8th Ave. 815 E. Juan Sanchez Blvd. Yuma, AZ San Luis, AZ Women's Health Specialists of Yuma Brian Grogan, MD Raja Mittapalli, MD 2911 S. 8th Ave. 115 N. Somerton Ave. Yuma, AZ Somerton, AZ Yuma Women Clinic - Yuma IPA Nader Haddard, MD Raja Mittapalli, MD 1025 W. 24th St, Ste W. 24th St. Yuma, AZ Yuma, AZ Women's Health Specialists of Yuma Women's Health Specialists of Yuma Marsha Keechler, NMW Alejandrina Orpineda, NP 2911 S. 8th Ave S. 8th Ave. Yuma, AZ Yuma, AZ Arizona Womens Health Center - Yuma IPA Women's Health Specialists of Yuma Kruthi Kelur, MD Thomas Suciu, MD 2095 W. 24th St., Ste. A 2911 S. 8th Ave. Yuma, AZ Yuma, AZ Zia - Yuma IPA Yuma Women Clinic - Yuma IPA Terry Lewis, MD Dania Sweidan, MD 2189 S. Avenue A 1025 W. 24th St, Ste 22 Yuma, AZ Yuma, AZ Associates for Women's Health Women's Health Specialists of Yuma Surendher Lokareddy, MD James Vining, MD 1945 W. 24th St S. 8th Ave. Yuma, AZ Yuma, AZ Women's Health Specialists of Yuma Keith Lutter, DO Werner Wester-Ebbinghaus, MD 815 E. Juan Sanchez Blvd S. 8th Ave. San Luis, AZ Yuma, AZ Keith Lutter, DO 115 N. Somerton Ave. Somerton, AZ Keith Lutter, DO 2060 W. 24th St. Yuma, AZ Women's Health Specialists of Yuma Erick Martinez, MD 2911 S. 8th Ave. Yuma, AZ * Use of the Participating Providers on the following pages are part of your plan, but may require a higher copayment than the use of the Designaed Participating PCP Providers Eff 1/1/2014_rev1_ Page 9 of 18

13 Wesstern Growers Assurance Trust CALIFORNIA FRESNO COUNTY West Fresno Community Health Center Israel Brown, DO 302 Fresno St., Ste. 101 Fresno, CA Elm Women's and Pediatric CHC Parastoo Farhady, MD 2760 S. Elm Ave. Parastoo Farhady, MD Fresno, CA Regional Medical Community Health Center Ryan Johnson, DO 2505 E. Divisadero St. Fresno, CA Gail Mallard-Warren, MD 6107 N. First Ave., Ste. 103 Fresno, CA Elm Women's and Pediatric CHC Eldridge Pearsall, MD 2760 S. Elm Ave. Parastoo Farhady, MD Fresno, CA Orange and Butler Community Health Center Evelen Soliman, DO 1350 S. Orange Ave. Fresno, CA IMPERIAL COUNTY Pediatrics Marisel Chibas, MD Vishwa Kapoor, MD 2302 Merrill Center Dr S. Imperial Ave., Ste. A El Centro, CA El Centro, CA Hamid Zadeh, MD 751 W. Legion Rd., Ste. 203 Brawley, CA * Use of the Participating Providers on the following pages are part of your plan, but may require a higher copayment than the use of the Designaed Participating PCP Providers Eff 1/1/2014_rev1_ Page 10 of 18

14 CALIFORNIA Wesstern Growers Assurance Trust KERN COUNTY Family Practice Pediatrics Bakersfield Family Medical Center South Bakersfield Community Health Center Delano Community Health Center Riverwalk Pediatrics Amira Ayad, MD Todd Andrews, MD Rhonda Robinson, MD Maria Rueras, MD 4580 California Ave 2400 Wible Rd., Ste Garces Hwy., Ste Stockdale Hwy., Ste. 150 Bakersfield, CA Bakersfield, CA Delano, CA Bakersfield, CA Bakersfield Family Medical Center Lamont Community Health Center Central Bakersfield Community Health Center Bakersfield Family Medical Center Susan Cribbs, DO Chibuike Anucha, MD Doreen Tadokoro, DO Maria Santos, MD 432 S. Mill St Hall Rd. 301 Brundage Lane 4580 California Ave Tehachapi, CA Lamont, CA Bakersfield, CA Bakersfield, CA Bakersfield Family Medical Center Central Bakersfield Community Health Center East Bakersfield Community Health Center Bakersfield Family Medical Center Benita Cushingberry-Turner, MD Karen Berk, NPCNM Vyn Wayne, WHNP Bharati Shah, MD 5601 Auburn St., Ste A 301 Brundage Lane 815 Dr. Martin Luther King Jr. Blvd California Ave Bakersfield, CA Bakersfield, CA Bakersfield, CA Bakersfield, CA (661) Bakersfield Family Medical Center Lamont Community Health Center Family Health Center Riverwalk Pediatrics Srilakshmi Madhusudhan, MD Lawrence Garcia, MD Hans Yu, DO Marilou Veloso, MD 3400 Calloway Dr, Ste Hall Rd st Street 9508 Stockdale Hwy., Ste. 150 Bakersfield, CA Lamont, CA Bakersfield, CA Bakersfield, CA Bakersfield Family Medical Center Arvin Community Health Center Arvin Community Health Center Peyton Riggs, DO Andrea Garland, MD Lydia Zapanta, MD 432 S. Mill St Bear Mountain Blvd Bear Mountain Blvd. Tehachapi, CA Arvin, CA Arvin, CA Bakersfield Family Medical Center South Bakersfield Community Health Center Pediatrics Don Tran, MD Tamas Kocsis, MD Riverwalk Pediatrics 4580 California Ave 2400 Wible Rd., Ste. 14 Hasmukh Amin, MD Bakersfield, CA Bakersfield, CA Stockdale Hwy., Ste Bakersfield, CA Internal Medicine Central Bakersfield Community Health Center Bakersfield Family Medical Center Hung Luu, MD Riverwalk Pediatrics Anne Onyekwuluje, MD 301 Brundage Lane Valerie Cayabyab-Garcia, MD 4580 California Ave Bakersfield, CA Stockdale Hwy., Ste. 150 Bakersfield, CA Bakersfield, CA East Bakersfield Community Health Center Vincent Matera, MD Riverwalk Pediatrics 815 Dr. Martin Luther King Jr. Blvd. Marissa Deleon, MD Bakersfield, CA Stockdale Hwy., Ste Bakersfield, CA LOS ANGELES COUNTY Shobhana Gandhi, MD Eduard Minas, MD 1300 N. Vermont Ave., Ste N. Vermont Ave., Ste. 307 Los Angeles, CA Los Angeles, CA Armine Ghazaryan, MD Samantha Stoll, NP 1300 N. Vermont Ave., Ste N. Vermont Ave., Ste. 307 Los Angeles, CA Los Angeles, CA Samantha Han, MD Bo Suh, MD 191 S. Buena Vista St., Ste W. Olympic Blvd., Ste 205 Burbank, CA Los Angeles, CA Samantha Han, MD Arus Zograbyan, MD 3323 W. Olympic Blvd., Ste N. Vermont Ave., Ste. 307 Los Angeles, CA Los Angeles, CA LA Lee Medical Associates Sangjoon Lee, MD 3130 W. Olympic Blvd., Ste. 360 Los Angeles, CA * Use of the Participating Providers on the following pages are part of your plan, but may require a higher copayment than the use of the Designaed Participating PCP Providers Eff 1/1/2014_rev1_ Page 11 of 18

15 Wesstern Growers Assurance Trust CALIFORNIA MONTEREY COUNTY Family Practice Family Practice Natividad Medical Center Natividad Medical Center Natividad Medical Center Valerie Bengal, MD Minerva Perez-Lopez, MD Brian Aguilera, MD 1441 Constitution Blvd Constitution Blvd Constitution Blvd. Salinas, CA Salinas, CA Salinas, CA Natividad Medical Center Natividad Medical Center Natividad Medical Center Adam Bolour, MD Kathryn Rios, MD Richard Alexander, MD 1441 Constitution Blvd Constitution Blvd Constitution Blvd. Salinas, CA Salinas, CA Salinas, CA Soledad Medical Clinic Natividad Medical Center Natividad Medical Center Jaime Giron, MD Carla Rosal, MD Peter Chandler, MD 600 Main St Constitution Blvd Constitution Blvd. Soledad, CA Salinas, CA Salinas, CA Natividad Medical Center Natividad Medical Center Natividad Medical Center Aurelio Gonzalez, MD Stephen Saglio, MD Ricardo Cuadros, MD 1441 Constitution Blvd Constitution Blvd Constitution Blvd. Salinas, CA Salinas, CA Salinas, CA Natividad Medical Center Natividad Medical Center Natividad Medical Center Gary Gray, DO John Silva, MD Lawrence Lenz, MD 1441 Constitution Blvd Constitution Blvd Constitution Blvd. Salinas, CA Salinas, CA Salinas, CA Natividad Medical Center Natividad Medical Center Natividad Medical Center Laurel Grimm, MD Marc Tunzi, MD Michelle Liamidi, MD 1441 Constitution Blvd Constitution Blvd Constitution Blvd. Salinas, CA Salinas, CA Salinas, CA Natividad Medical Center Natividad Medical Center Natividad Medical Center Charles Harris, MD Jeannine Wahl, DO Caleb Liem, MD 1441 Constitution Blvd Constitution Blvd Constitution Blvd. Salinas, CA Salinas, CA Salinas, CA Natividad Medical Center Internal Medicine Pediatrics Steven Harrison, MD Natividad Medical Center Natividad Medical Center 1441 Constitution Blvd. Ghislaine Guez, MD Debra Bright, MD Salinas, CA Constitution Blvd Constitution Blvd Salinas, CA Salinas, CA Natividad Medical Center Wendell Harry, MD Natividad Medical Center Natividad Medical Center 1441 Constitution Blvd. Sir Cedric Ibanez III, MD Rolando Cantos, MD Salinas, CA Constitution Blvd Constitution Blvd Salinas, CA Salinas, CA Natividad Medical Center Paige Moore, MD Natividad Medical Center Natividad Medical Center 1441 Constitution Blvd. M-Shahid Khan, MD Margaret-Anne Fernandez, MD Salinas, CA Constitution Blvd Constitution Blvd Salinas, CA Salinas, CA Natividad Medical Center Samer Muala, MD Natividad Medical Center Natividad Medical Center 1441 Constitution Blvd. Omeed Sani, MD Edward Kody, MD Salinas, CA Constitution Blvd Constitution Blvd Salinas, CA Salinas, CA Natividad Medical Center Trupti Nitin Nangar, MD Natividad Medical Center 1441 Constitution Blvd. Michael Sepulveda, MD Salinas, CA Constitution Blvd Salinas, CA Natividad Medical Center Angel Parker, MD Natividad Medical Center 1441 Constitution Blvd. Anuj Vaid, MD Salinas, CA Constitution Blvd Salinas, CA Natividad Medical Center Mario Pauda, MD 1441 Constitution Blvd. Salinas, CA * Use of the Participating Providers on the following pages are part of your plan, but may require a higher copayment than the use of the Designaed Participating PCP Providers Eff 1/1/2014_rev1_ Page 12 of 18

16 CALIFORNIA Wesstern Growers Assurance Trust RIVERSIDE COUNTY Sudha Moola, MD 3975 Jackson St., Ste. 208 Riverside, CA Pediatrics Tannaz Hild, MD 7101 Magnolia Ave., Ste. A Riverside, CA Pediatric Medical Group of Riverside Alan Kwasman, MD 6950 Brockton Ave., Ste. 5 Riverside, CA Pediatric Medical Group of Riverside Timothy Mackey, MD 6950 Brockton Ave., Ste. 5 Riverside, CA Monika Mustafa, MD 7101 Magnolia Ave., Ste. A Riverside, CA Touraj Shafai, MD 7101 Magnolia Ave., Ste. A Riverside, CA SACRAMENTO COUNTY Capital Inc. Mala Ashok, MD 77 Cadillac Dr., Ste. 230 Sacramento, CA Capital Inc. Bruce Bob, MD 77 Cadillac Dr., Ste. 230 Sacramento, CA Capital Inc. Jay Curkendall, MD 77 Cadillac Dr., Ste. 230 Sacramento, CA Capital Inc. Ian Donald, MD 77 Cadillac Dr., Ste. 230 Sacramento, CA Capital Inc. Tanya Maagdenberg, MD 77 Cadillac Dr., Ste. 230 Sacramento, CA Mark Zhang, MD 1740 Fruitridge Rd., Ste. 103 Sacramento, CA Capital Inc. Matthew Susanka, MD 77 Cadillac Dr., Ste. 230 Sacramento, CA * Use of the Participating Providers on the following pages are part of your plan, but may require a higher copayment than the use of the Designaed Participating PCP Providers Eff 1/1/2014_rev1_ Page 13 of 18

17 CALIFORNIA Wesstern Growers Assurance Trust SAN DIEGO COUNTY West Coast OB/Gyn West Coast OB/Gyn Lauren Bales, MD Daniela Meshkat, MD 7695 Cardinal Ct., Ste Cardinal Ct., Ste. 240 San Diego, CA San Diego, CA Women's Health Care Women's Health Care Shereen Binno, MD Rovena Reagan, MD 8010 Frost St., Ste Frost St., Ste. 301 San Diego, CA San Diego, CA Women's Health Care West Coast OB/Gyn Bhoomi Brahmbhatt, MD Craig Saffer, MD 8010 Frost St., Ste Cardinal Ct., Ste. 240 San Diego, CA San Diego, CA West Coast OB/Gyn Amy French, MD 7695 Cardinal Ct., Ste. 240 San Diego, CA West Coast OB/Gyn Kim Goodwin, MD 7695 Cardinal Ct., Ste. 240 San Diego, CA Women's Health Care Dana Huskey, MD 8010 Frost St., Ste. 301 San Diego, CA Women's Health Care Colleen McNally, MD 8010 Frost St., Ste. 301 San Diego, CA SANTA BARBARA COUNTY Internal Medicine Pediatrics Main Medical Center Inc. Jeffrey Kaplan, MD Michael Kazak, MD 301 S. Miller St, Ste W. Main St. Santa Maria, CA Santa Maria, CA (805) (805) Pediatric Medical Group of Santa Maria Hypertension Nephrology & I.M. Group Samira Kayumi-Rashti, MD Dharmapaul Raju, MD 1430 E. Main St # E. Main St. Santa Maria, CA Santa Maria, CA (805) Pediatric Medical Group of Santa Maria Michele Kielty, MD Mitchell Adler, MD 1430 E. Main St # E. Cypress St., Ste. B Santa Maria, CA Santa Maria, CA (805) Pediatric Medical Group of Santa Maria Center for Women's Health & Family Birth David Ikola, MD Michael Enrico, MD 1430 E. Main St # S. Palisade, Ste. 101 Santa Maria, CA Santa Maria, CA (805) Pediatric Medical Group of Santa Maria Joseph Nunez, MD 1430 E. Main St #201 Santa Maria, CA (805) Pediatric Medical Group of Santa Maria George Robertson, MD 1430 E. Main St #201 Santa Maria, CA (805) ` * Use of the Participating Providers on the following pages are part of your plan, but may require a higher copayment than the use of the Designaed Participating PCP Providers. Eff 1/1/2014_rev1_ Page 14 of 18

18 Wesstern Growers Assurance Trust CALIFORNIA SANTA CRUZ COUNTY Pediatrics Coastal Women's Healthcare Pediatric Group of Watsonville Cheryl Northey, MD Patrick Clyne, MD 65 Nielson St., Ste Green Valley Rd Watsonville, CA Freedom, CA STANISLAUS COUNTY Modesto Arts Medical Group Sean Clare, MD 1400 Florida Ave., Ste. 207 Modesto, CA (209) Modesto Arts Medical Group Christopher Harvey, MD 1400 Florida Ave., Ste. 207 Modesto, CA (209) Modesto Arts Medical Group John Pfeffer, MD 1400 Florida Ave., Ste. 207 Modesto, CA (209) Women to Women Medical Group Susan Podolsky, MD 2603 Patterson Rd., Ste. 1 Riverbank, CA Modesto Arts Medical Group Randy Winter, MD 1400 Florida Ave., Ste. 207 Modesto, CA (209) * Use of the Participating Providers on the following pages are part of your plan, but may require a higher copayment than the use of the Designaed Participating PCP Providers. Eff 1/1/2014_rev1_ Page 15 of 18

19 CALIFORNIA Wesstern Growers Assurance Trust VENTURA COUNTY Family Practice Family Practice Family Practice Family Practice Nasr Anees, MD Theresa Cho, MD Kenneth Finger, MD John Ippolito, MD 355 Central Ave 325 W. Channel Island Blvd 2400 S. C Street 612 Spring Rd, Bldg A Fillmore, CA Oxnard, CA Oxnard, CA Moorpark, CA (805) (805) (805) Preston Arndt, MD Connell Davis, MD Sheila Flom, MD Shilpa Jindani, MD 2220 E. Gonzales Rd, Ste 120A 1334 E. Main St E. Los Angeles Ave 125 W. Thousand Oaks Bl #300 Oxnard, CA Santa Paula, CA Simi Valley, CA Thousand Oaks, CA (805) (805) (805) (805) Jeremy Bennett, MD Lanyard Dial, MD Wendy Francke, MD Christine Johnson, MD 325 W. Channel Island Blvd 1996 Eastman Ave, Ste W. Santa Clara St 828 Ventura Street Oxnard, CA Ventura, CA Ventura, CA Fillmore, CA (805) (805) (805) Eric Birdwell, MD Sheryl Dickstein, MD Carlos Frias, MD Susan Johnson, MD 5850 Thille St, Ste Loma Vista Rd, Bldg. 340, Ste N. Tenth St 2400 S. C Street Ventura, CA Ventura, CA Santa Paula, CA Oxnard, CA (805) (805) (805) (805) Allison Blaze, MD Timothy Donahue, MD Lyudmyla Gareys, MD Amy Jones, MD 2400 S C. Street 1227 E. Los Angeles Ave 1227 E. Los Angeles Ave 612 Spring Rd, Bldg A Oxnard, CA Simi Valley, CA Simi Valley, CA Moorpark, CA (805) (805) (805) (805) Stuart Bloom, MD Gillian Dorner, MD Ramon Gomez, MD Neil Jorgensen, MD 2533 E. Main St S. C Street 1334 E. Main Street 3291 Loma Vista Rd, Bldg 340, Ste 201 Ventura, CA Oxnard, CA Santa Paula, CA Ventura, CA (805) (805) (805) (805) Jaehyun Byun, MD Christine Dumont, MD Alicia Guevara, MD Seong Kang, MD 845 N. Tenth St 2240 E. Gonzales Rd, Ste W. Channel Islands Blvd. 125 W. Thousand Oaks Bl #300 Santa Paula, CA Oxnard, CA Oxnard, CA Thousand Oaks, CA (805) (805) (805) (805) Lisabeth Carlisle, MD Thomas Duncan, MD Mikael Hakansson, MD Nicole Kehoe, MD 2220 E. Gonalez Rd, Ste 120A-B 3291 Loma Vista Rd, Bldg 340, Ste Sespe Ave, Ste C 1334 E. Main Street Oxnard, CA Ventura, CA Fillmore, CA Santa Paula, CA (805) (805) (805) Paolo Carvalho, MD Thomas Dunlop, MD Laura Harman, MD Catherine Kim, MD 125 W. Thousand Oaks Blvd # Loma Vista Rd, Bldg 340, Ste Telegraph Rd 612 Spring Rd, Bldg A Thousand Oaks, CA Ventura, CA Ventura, CA Moorpark, CA (805) (805) (805) (805) Catarina Castaneda, MD Jeff Dyer, MD James Helmer, MD Jeffrey King, MD 845 N. Tenth St 2953 Telegraph Rd 3291 Loma Vista Rd, Bldg 340, Ste Loma Vista Rd Santa Paula, CA Ventura, CA Ventura, CA Ventura, CA (805) (805) (805) (805) Uldine Castel, MD Autumn Edwards, MD James Hermann, MD Natalie Ladine, MD 3438 Loma Vista Rd 325 W. Channel Islands Blvd 5850 Thille Street, Ste E. Main Street Ventura, CA Oxnard, CA Ventura, CA Santa Paula, CA (805) (805) (805) (805) Richard Cegelski, MD Linda England, MD Pamela Holbrook, MD Cheryl Lambing, MD 350 Paseo De Playa # N. Ashwood Ave 125 W. Thousand Oaks Bl # Loma Vista Rd, Bldg 340, Ste 201 Ventura, CA Ventura, CA Thousand Oaks, CA Ventura, CA (805) (805) (805) (805) Miguel Cervantes, MD Joseph Esherick, MD Renee Hook, MD Fran Larsen, MD 2400 South C Street 3291 Loma Vista Rd, MSO 1227 E. Los Angeles Ave 3291 Loma Vista Rd, Bldg 340, Ste 201 Oxnard, CA Ventura, CA Simi Valley, CA Ventura, CA (805) (805) (805) (805) Darin Chambers, MD John Fankhauser, MD James Hornstein, MD Mark Lepore, MD 2400 South C Street 3291 Loma Vista Rd 2793 Loma Vista Rd 3291 Loma Vista Rd Oxnard, CA Ventura, CA Ventura, CA Ventura, CA (805) (805) (805) (805) * Use of the Participating Providers on the following pages are part of your plan, but may require a higher copayment than the use of the Designaed Participating PCP Providers. Eff 1/1/2014_rev1_ Page 16 of 18

20 Wesstern Growers Assurance Trust CALIFORNIA VENTURA COUNTY Family Practice Family Practice Family Practice Internal Medicine Grace Lin, MD Albert Reeves, MD Michael Tushla, MD Ksenija Peharda, MD 825 N. Tenth Street 2220 Gonzales Rd, Suite 210B 400 E. Santa Barbara St, Ste A 325 Channel Islands Blvd Santa Paula, CA Oxnard, CA Santa Paula, CA Oxnard, CA (805) (805) (805) (805) Alan Lyne, MD Lynn Rockney, MD Maria Villasenor, MD Stephanus Philip, MD 245 N. 10th Street 2220 Gonzales Rd, Ste 120A 2200 E. Gonzales Rd. 845 N. Tenth Street Santa Paula, CA Oxnard, CA Oxnard, CA Santa Paula, CA (805) (805) (805) (805) Alexander Meyer, MD Bill Rogers, MD Gary Wikholm, MD Gail Simpson, MD 400 E. Santa Barbara, Suite A 3291 Loma Vista Rd, Bldg 340, Ste W. Harvard Blvd Loma Vista Rd Santa Paula, CA Ventura, CA Santa Paula, CA Ventura, CA (805) (805) (805) (805) Edwina Skinner, MD Anna Mikhailovsky, MD Jason Rowley, MD Bryan Wong, MD 325 W. Channel Island Blvd 3801 Las Posas Rd, Suite Loma Vista Rd 3291 Loma Vista Rd, Bldg 340, Ste 201 Oxnard, CA Camarillo, CA Ventura, CA Ventura, CA (805) (805) (805) Michael Swartout, MD Rose Milankes-Skopp, MD Nabeel Saeed, MD Michelle Yates, MD 247 March St Las Posas Rd, Suite S. Wells Rd., Suite W. Thousand Oaks Bl #300 Santa Paula, CA Camarillo, CA Ventura, CA Thousand Oaks, CA (805) (805) (805) Internal Medicine Ramsey Ulrich, MD Jeffrey Miller, MD Catherine Sever, MD 133 W. Santa Clara St Las Posas Rd, Suite W. Channel Island Blvd. Michelle Azimov, MD Ventura, CA Camarillo, CA Oxnard, CA N. Tenth St (805) (805) Santa Paula, CA (805) Lois Barnes, MD Carolyn Morris, MD Kavitha Simpson, MD 3460 Loma Vista Rd. 825 N. Tenth Street 2240 E. Gonzales Rd, Ste 100 Jian Chen, MD Ventura, CA Santa Paula, CA Oxnard, CA March St (805) (805) Santa Paula, CA (805) Mirela Cernaianu, MD Khristina Mueller, MD Kristi Schoeld, MD 2400 South C Street 612 Spring Rd, Bldg A 3291 Loma Vista Rd Robert Dekkers, MD Oxnard, CA Moorpark, CA Ventura, CA March St. (805) (805) (805) Santa Paula, CA (805) Ventura County Medical Group Steven Coyle, MD Shilpa Pakala, MD Mark Smith, MD 2795 Loma Vista Rd E. Gonzales Rd, Ste W. Thousand Oaks Bl #300 Gary Deutsch, MD Ventura, CA Oxnard, CA Thousand Oaks, CA March St (805) (805) Santa Paula, CA (805) Ventura County Medical Group John Gustafson, MD Rosalie Patricio, MD Scott Speier, MD 2795 Loma Vista Rd. 450 W. Clara Street 3291 Loma Vista Rd Bora Kim, MD Ventura, CA Oxnard, CA Ventura, CA March St (805) (805) Santa Paula, CA (805) Ventura County Medical Group Jill Hall, MD Anuchit Pattanachinda, MD Lisa Solinas, MD 2795 Loma Vista Rd. 200 N. Hillmont Ave 825 N. Tenth Street Leah Kory, MD Ventura, CA Ventura, CA Santa Paula, CA Loma Vista Rd (805) (805) Ventura, CA (805) Antoine Hanna, MD 1700 N. Rose Ave., Ste. 230 Stanley Patterson, MD Marisa Sportelli, MD Oxnard, CA Gonzales Rd, Ste 120A 1227 E. Los Angeles Ave Eric Leibovitch, MD Oxnard, CA Simi Valley, CA Loma Vista Rd (805) (805) Ventura, CA (805) Frederick Kelley, MD 3291 Loma Vista Rd, Bldg 340, Ste 403 Leslie Lynn Pawson, MD Sunita Sujanani, MD Ventura, CA Loma Vista Rd, Bldg 340, Ste W. Santa Clara Nancy Merrick, MD (805) Ventura, CA Ventura, CA Gonzales Rd, Ste 100 (805) (805) Oxnard, CA (805) Robert Lefkowitz, MD 2000 Outlet Center Dr, Ste 110 Miguel Pedroza, MD Andraus Thurman, MD Oxnard, CA E. Gonzales Rd, Ste S. C Street Riffat Muzaffer, MD (805) Oxnard, CA Oxnard, CA E. Los Angeles Ave (805) (805) Simi Valley, CA (805) * Use of the Participating Providers on the following pages are part of your plan, but may require a higher copayment than the use of the Designaed Participating PCP Providers. Eff 1/1/2014_rev1_ Page 17 of 18

21 Wesstern Growers Assurance Trust CALIFORNIA VENTURA COUNTY Pediatrics Pediatrics Todd Monroe, MD Janelle Bohl, MD Connie Li, MD 1300 Ventura Rd, Ste W. Harvard Street, Ste B 200 S. Wells Rd., Ste 100 Oxnard, CA Santa Paula, CA Ventura, CA (805) (805) (805) Veena Mummaneni, MD 1700 N. Rose Ave., Ste. 350 Darren Bray, MD Daniel Lu, MD Oxnard, CA Outlet Center Drive Ste Outlet Center Drive Ste Oxnard, CA Oxnard, CA (805) (805) Gary Nishida, MD 933 W. 7th St. Oxnard, CA Todd Flosi, MD Suhad Niazi, MD Loma Vista Rd 3291 Loma Vista Rd, Bldg 340, Ste 302 Ventura, CA Ventura, CA (805) (805) Johannes Ramirez, MD 650 Hobson Way, Ste 201 Oxnard, CA Amy Galin, MD Paul Russell, MD (805) Las Posas Rd, Ste E. Gonzales Rd Camarillo, CA Oxnard, CA Ventura County Medical Group (805) Richard Reisman, MD 2795 Loma Vista Rd. Ventura, CA Sonya Garcia, MD Hang Tran, MD Outlet Ctr Dr, Ste Outlet Center Drive Ste 110 Oxnard, CA Oxnard, CA (805) (805) Ira Silverman, MD 3291 Loma Vista Rd, Bldg 340, Ste 403 Ventura, CA Shadi Al Khatib, MD (805) S. Wells Rd, Ste 200 Ventura, CA (805) Thuc Ta, MD 200 S. Wells Rd, Ste 200 Ventura, CA Rekha Krishnankutty, MD (805) E. Los Angeles Ave Simi Valley, CA (805) Juan Vega, MD 3291 Loma Vista Rd, Bldg 340, #403 Ventura, CA Michelle a, MD (805) Outlet Center Dr Ste 110 Oxnard, CA (805) Minako Watabe, MD 845 N. Tenth St, Ste 3 Santa Paula, CA Chris Landon, MD (805) Loma Vista Rd, Bldg 340, Ste 302 Ventura, CA Pediatrics (805) Maria Arizmendi, MD 2000 Outlet Center Dr Ste 110 Sun Lee, MD Oxnard, CA Loma Vista Rd, Bldg 340, Ste 302 (805) Ventura, CA (805) Andrei Bobrow, MD 2400 S. C Street Robert Levin, MD Oxnard, CA E. Gonzales Rd, Ste 210 (805) Oxnard, CA (805) * Use of the Participating Providers on the following pages are part of your plan, but may require a higher copayment than the use of the Designaed Participating PCP Providers. Eff 1/1/2014_rev1_ Page 18 of 18