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    It’s Time to Fight the Diabetes Epidemic

    Dr. Jim Wu of LaSalle Medical Associates says, “New diabetic cases are increasing by about one to two million new cases per year in the United States. In San Bernadino County, there are over 90 percent mortalities related to diabetes and its complications. LaSalle Medical Associates is facing unprecedented challenges in fighting the diabetic pandemic.”

    Dr. Jim Wu of LaSalle Medical Associates says, “New diabetic cases are increasing by about one to two million new cases per year in the United States. In San Bernadino County, there are over 90 percent mortalities related to diabetes and its complications. LaSalle Medical Associates is facing unprecedented challenges in fighting the diabetic pandemic.”

    “Proper screening and case management are the keys to living well with diabetes,” said Dr. Jim Wu of LaSalle Medical Associates.

    REDLANDS, CALIF. –—Statistics compiled by the Centers for Disease Control and Prevention show that 14.5 percent of American Indians or Alaskan Natives, 12.1 percent of non-Hispanic Blacks and 11.7 percent of Hispanics aged 18 and older were diagnosed with diabetes from 2019 to 2021. This compares with 9.1 percent of non-Hispanic Asians and 6.9 percent of whites.

    November is Diabetes Awareness Month and the perfect time to get tested for diabetes. The old distinctions about when one might contract type 1 or type 2 diabetes in terms of the age differential have been closing, as type 2 has become more common among young people.

    Another important point is that while screening may result in a negative finding for diabetes, it may also find evidence of prediabetes, which calls for lifestyle and dietary changes, as well as regular check-ins with your healthcare provider.

    The Mayo Clinic notes that symptoms of type 1 diabetes “often start suddenly and are often the reason for checking blood sugar levels. Because symptoms of other types of diabetes and prediabetes come on more gradually or may not be easy to see, the American Diabetes Association (ADA) has developed screening guidelines.

    • Anyone with a body mass index higher than 25 (23 for Asian Americans), regardless of age,who has additional risk factors. These factors include high blood pressure, non-typical cholesterol levels, an inactive lifestyle, a history of polycystic ovary syndrome or heart disease, and having a close relative with diabetes.
    • Anyone older than age 35is advised to get an initial blood sugar screening. If the results are normal, they should be screened every three years after that.
    • Women who have had gestational diabetes are advised to be screened for diabetes every three years.
    • Anyone who has been diagnosed with prediabetes is advised to be tested every year.
    • Anyone who has HIVis advised to be tested.”

    LaSalle Medical Associates has four ways to test for type 1 and type 2 diabetes and prediabetes.

    • AIC test. This blood test doesn’t require fasting. It shows your average blood sugar level for the past 2 to 3 months. It’s also called a glycated hemoglobin test.
    • Random blood sugar test. No matter when you last ate, a blood sugar level of 200 milligrams per deciliter or higher suggests diabetes.
    • Fasting blood sugar test. After fasting overnight, a blood sugar level of less than 100 mg/dL is normal. A fasting blood sugar level from 100 to 125 mg/dL is considered prediabetes. If it’s 126 mg/dL or higher on two separate tests, you have diabetes.
    • Glucose tolerance test. You fast overnight. Then, the fasting blood sugar level is measured, and you then drink a sugary liquid. Blood sugar levels are tested regularly for the next two hours.

    Dr. Jim Wu of LaSalle Medical Associates says, “New diabetic cases are increasing by about one to two million new cases per year in the United States. In San Bernadino County, there are over 90 percent mortalities related to diabetes and its complications. LaSalle Medical Associates is facing unprecedented challenges in fighting the diabetic pandemic.”

    Dr. Albert Arteaga, Chair of LaSalle Medical Associates, adds, “As a Latino myself, I am well aware that Latinos and other people of color are more prone to developing diabetes. Don’t put off getting tested. See your healthcare provider so that you stick around for your friends and family for a long, long time.”

    Depending on the type of diabetes, blood sugar monitoring, insulin and oral drugs may be part of your treatment. Eating a healthy diet, staying at a healthy weight and getting regular physical activity also are important parts of managing diabetes.

    “Proper screening and case management are the keys to living well with diabetes,” said Dr. Wu.

    LaSalle Medical Associates serves more than 350,000 patients in their clinics and statewide Independent Physicians Association Group (IPA). They accept most insurance including Medi-Cal, Medicare and Covered California, as well as those covered by Blue Cross, Blue Shield, Brand New Day, Molina, Care 1st, Health Net and Inland Empire Health Plan (IEHP).

    For more information call 1-855-349-6019 or go online to LaSalleMedical.com.

    —30—

    B R I E F: 287 Words

    It’s Time to Fight the Diabetes Epidemic

    “Proper screening and case management are the keys to living well with diabetes,” said Dr. (name here) of LaSalle Medical Associates.

    REDLANDS, CALIF. –—Statistics compiled by the Centers for Disease Control and Prevention show that 14.5 percent of American Indians or Alaskan Natives, 12.1 percent of non-Hispanic Blacks and 11.7 percent of Hispanics aged 18 and older were diagnosed with diabetes from 2019 to 2021. This compares with 9.1 percent of non-Hispanic Asians and 6.9 percent of whites.

    November is Diabetes Awareness Month and the perfect time to get tested for diabetes. The old distinctions about when one might contract type 1 or type 2 diabetes in terms of the age differential have been closing, as type 2 has become more common among young people.

    Dr. Albert Arteaga, Chair of LaSalle Medical Associates, says, “As a Latino myself, I am well aware that Latinos and other people of color are more prone to developing diabetes. Don’t put off getting tested. See your healthcare provider so that you stick around for your friends and family for a long, long time.”

    Depending on the type of diabetes, blood sugar monitoring, insulin and oral drugs may be part of your treatment. Eating a healthy diet, staying at a healthy weight and getting regular physical activity also are important parts of managing diabetes.

    LaSalle Medical Associates serves more than 350,000 patients in their clinics and statewide Independent Physicians Association Group (IPA). Patients are covered by Medi-Cal, Medicare and Covered California, as well as those covered by Blue Cross, Blue Shield, Brand New Day, Molina, Care 1st, Health Net and Inland Empire Health Plan (IEHP).

    For more information call 1-855-349-6019 or go online to LaSalleMedical.com.

    About LaSalle Medical Associates

    LaSalle Medical Associates, Inc. is one of the largest independent and Latino-owned healthcare companies in Riverside and San Bernardino Counties. The corporate office is in Redlands.

    LaSalle is also an Independent Practice Association (IPA) of independently contracted doctors, hospitals, and clinics, delivering high-quality patient care to over 350,000 patients in Fresno, Kings, Los Angeles, Madera, Riverside, San Bernardino and Tulare counties.

    New Ways to Prevent RSV Infections

    RSV's symptoms include runny nose, loss of appetite, coughing, sneezing, fever, and wheezing. In most cases, these symptoms show up in stages, rather than all at once. In very young infants, "the only symptoms may be irritability, decreased activity, and breathing difficulties," per the CDC. Shiane and Shaila Dameron parents use preventive medicine. The children have all of their vaccines and receive checkups with their doctors every six months.

    RSV’s symptoms include runny nose, loss of appetite, coughing, sneezing, fever, and wheezing. In most cases, these symptoms show up in stages, rather than all at once. In very young infants, “the only symptoms may be irritability, decreased activity, and breathing difficulties,” per the CDC. Shiane and Shaila Dameron parents use preventive medicine. The children have all of their vaccines and receive checkups with their doctors every six months.

    “RSV is a cold-like virus that is usually mild but can put some people in the hospital,” says Dr. Cheryl Emoto, Medical Director of LaSalle Medical Associates. “For the first time this fall, young infants and seniors (those with the highest risk for severe disease) now have a way to prevent it.”

    SAN BERNARDINO, CALIF. – A new monoclonal antibody and new anti-viral vaccines are coming for the first time to provide protection against RSV, Respiratory Syncytial (sin-SISH-uhl) Virus. LaSalle Medical Associates clinics will be providing these breakthroughs to patients this fall.

    “RSV is a cold-like virus that is usually mild but can put some people in the hospital,” says Dr. Cheryl Emoto, Medical Director of LaSalle Medical Associates. “For the first time this fall, young infants and seniors (those with the highest risk for severe disease) now have a way to prevent it.”

    The Centers for Disease Control and Prevention notes that “Most people recover in a week or two, but RSV can be serious. Infants and older adults are more likely to develop severe RSV and need hospitalization. Vaccines are available to protect older adults from severe RSV. Monoclonal antibodies are available to protect infants.”

    The CDC goes on to note that RSV is “one of the most common causes of childhood illness and is the most common cause of hospitalization among infants [emphasis ours].” It usually starts in the fall and peaks in the winter, but this can vary.

    Monoclonal antibodies and vaccines may now prevent RSV. A monoclonal antibody is a clone of a unique white blood cell (white blood cells are the body’s own infection fighters) given to augment and reinforce the body’s natural defenses. It’s the option available for infants who are entering their first RSV season. They are not used when someone already has RSV.

    Up until now, almost all children have contracted RSV by the time they reach 24 months, so the new prevention regimen has the potential to prevent illness and potential complications such as bronchitis and pneumonia, making life easier for both infants and their parents or caretakers.

    For older adults, the CDC estimates that between 60 to 100 thousand are hospitalized every year. resulting in 6,000 to 10,000 deaths. The most at-risk cohorts are older adults, adults with chronic heart or lung disease, those with weakened immune systems or certain underlying medical conditions and residents in nursing homes or long-term care facilities.

    Complications may include asthma, chronic obstructive pulmonary disease (COPD, a chronic disease of the lungs that makes it hard to breathe), and congestive heart failure—when the heart can’t pump enough blood and oxygen through the body.

    Additionally, this year, there is now a regimen for pregnant women that keeps the developing fetus safe from infection. Now is the time to contact your healthcare provider to schedule an appointment for preventive care, especially if you are pregnant, have an infant under 8 months of age or are 60 years of age or older.

    LaSalle Medical Associates serves more than 350,000 patients in their clinics and statewide Independent Physicians Association Group (IPA) who are covered by Medi-Cal, Medicare, and Covered California, as well as those covered by Blue Cross, Blue Shield, Brand New Day, Molina, Care 1st, Health Net and Inland Empire Health Plan (IEHP).

    LaSalle staff also help people who come into a clinic without any insurance to become enrolled for a variety of state and federal health coverage.

    For more information call (909) 890-0407 or go online to LaSalleMedical.com.

    —30—

    B R I E F: 325 Words

    New Ways to Prevent RSV Infections 

    “RSV is a cold-like virus that is usually mild but can put some people in the hospital,” says Dr. Cheryl Emoto, Medical Director of LaSalle Medical Associates. “For the first time this fall, young infants and seniors (those with the highest risk for severe disease) now have a way to prevent it.”

    SAN BERNARDINO, CALIF. – A new monoclonal antibody and new anti-viral vaccines are coming for the first time to provide protection against RSV, Respiratory Syncytial (sin-SISH-uhl) Virus. LaSalle Medical Associates clinics will be providing these breakthroughs to patients this fall.

    “RSV is a cold-like virus that is usually mild but can put some people in the hospital,” says Dr. Cheryl Emoto, Medical Director of LaSalle Medical Associates. “For the first time this fall, young infants and seniors (those with the highest risk for severe disease) now have a way to prevent it.”

    The Centers for Disease Control and Prevention notes that “Most people recover in a week or two, but RSV can be serious. Infants and older adults are more likely to develop severe RSV and need hospitalization. Vaccines are available to protect older adults from severe RSV. Monoclonal antibodies are available to protect infants.”

    Monoclonal antibodies and vaccines can now help prevent RSV. A monoclonal antibody is a clone of a unique white blood cell (white blood cells are the body’s own infection fighters) given to augment and reinforce the body’s natural defenses. It’s the option available for infants entering their first RSV season. They are not used when someone already has RSV.

    RSV can lead to severe complications, such as asthma, bronchitis, chronic obstructive pulmonary disease (COPD, a chronic disease of the lungs that makes it hard to breathe), congestive heart failure (when the heart can’t pump enough blood and oxygen through the body) and pneumonia.

    For more information call (909) 890-0407 or go online to LaSalleMedical.com.

    About LaSalle Medical Associates

    LaSalle Medical Associates, Inc. is one of the largest independent and Latino-owned healthcare companies in Riverside and San Bernardino Counties. The corporate office is in Redlands.

    LaSalle is also an Independent Practice Association (IPA) of independently contracted doctors, hospitals, and clinics, delivering high-quality patient care to over 350,000 patients in Fresno, Kings, Los Angeles, Madera, Riverside, San Bernardino and Tulare counties.

    October Is Liver Cancer Awareness Month

    Photo Caption: “Early recognition of symptoms, proper physical examination, and swift intervention are the keys to survival. If you or a family member have any of these symptoms, see your doctor immediately or go to the emergency room,” said Dr. Andrew Benin, M.D.

    Photo Caption: “Early recognition of symptoms, proper physical examination, and swift intervention are the keys to survival. If you or a family member have any of these symptoms, see your doctor immediately or go to the emergency room,” said Dr. Andrew Benin, M.D.

    “Here At LaSalle, we always stress the importance of annual physical exams and proper follow-ups to screen for cancers and other conditions that increase the risk of liver cancer,” says Dr. Andrew Benin of LaSalle Medical Associates.

    REDLANDS, CALIF. –October is Liver Cancer Awareness Month, and The American Association for Cancer Research (AACR) aims to raise awareness about the warning signs of both types of liver cancer. The AACR notes that liver cancer is more prevalent in men than women, and it is more common among Asian/Pacific Islanders and American Indian/Alaska Natives.

    Dr. Andrew Benin of LaSalle Medical Associates says, “According to the NIH the incidence of liver cancer will increase by more than 50 percent and the number of deaths is projected to increase by more than 55 percent between 2020 and 2040. This is exactly why here at LaSalle, we always stress the importance of annual physical exams and proper follow-ups to screen for cancers and other conditions that increase the risk of liver cancer such as hepatitis.”

    “We encourage everyone to work on lifestyle modifications such as decreasing alcohol use, avoiding IV drug use, and limiting fatty foods. Ultimately, the best thing anybody can do for screening and prevention is to make an appointment and have a conversation with their healthcare provider. Early recognition of symptoms, proper physical examination, and swift intervention are the keys to survival.”

    The two types of primary adult liver cancer are liver cells (hepatocellular carcinoma) and liver bile duct cancer (cholangiocarcinoma). People who have cirrhosis or hepatitis B or C are especially at risk, according to the AACR.

    The National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program projects 41,210 new cases of liver and intrahepatic bile duct cancer in 2023, resulting in approximately 29,380 deaths. The five-year relative survival rate is only 21.6 percent.

    Symptoms for both liver cell cancer and bile duct cancer include losing weight without trying, yellowing of the skin and whites of the eyes (jaundice), and or white, chalky stools.

    Symptoms unique to liver cell cancer are loss of appetite, upper abdominal pain, nausea and vomiting, general weakness and fatigue, and abdominal swelling, Symptoms unique to bile duct cancer are intensely itchy skin, abdominal pain on the right side, below the ribs, fever, night sweats and dark urine.

    “Early recognition of symptoms, proper physical examination, and swift intervention are the keys to survival. If you or a family member have any of these symptoms, see your doctor immediately or go to the emergency room,” said Dr. Benin.

    LaSalle Medical Associates serves more than 350,000 patients in their clinics and statewide Independent Physicians Association Group (IPA). Patients are covered by Medi-Cal, Medicare, Covered California, Blue Cross, Blue Shield, Brand New Day, Molina, Care 1st, Health Net, and Inland Empire Health Plan (IEHP).

    For an appointment or more information about LaSalle Medical Associates, call 1-855-349-6019 or go online to LaSalleMedical.com.

    —30—

    B R I E F: 320 Words

    October Is Liver Cancer Awareness Month

    “Early recognition of symptoms, proper physical examination, and swift intervention are the keys to survival,” says Dr. Andrew Benin of LaSalle Medical Associates.

    REDLANDS, CALIF. –October is Liver Cancer Awareness Month, and The American Association for Cancer Research (AACR) aims to raise awareness about the warning signs of both types of liver cancer. The AACR notes that liver cancer is more prevalent in men than women, and it is more common among Asian/Pacific Islanders and American Indian/Alaska Natives.

    The National Cancer Institute projects 41,210 new cases of liver and bile duct cancer, with approximately 29,380 deaths for 2023. The five-year relative survival rate is just 21.6 percent.

    Symptoms for both liver cell cancer and bile duct cancer include losing weight without trying, yellowing of the skin and whites of the eyes (jaundice), and white, chalky stools.

    Symptoms unique to liver cell cancer are loss of appetite, upper abdominal pain, nausea and vomiting, general weakness and fatigue, and abdominal swelling, symptoms unique to bile duct cancer are intensely itchy skin, abdominal pain on the right side, below the ribs, fever, night sweats and dark urine.

    Dr. Andrew Benin of LaSalle Medical Associates, says, “According to the NIH the incidence of liver cancer would increase by more than 50 percent and the number of deaths would increase by more than 55 percent between 2020 and 2040. This is exactly why here At LaSalle, we always stress the importance of annual physical exams and proper follow-ups to screen for cancers and other conditions that increase the risk of liver cancer such as hepatitis.

    “Early recognition of symptoms, proper physical examination, and swift intervention are the keys to survival. If you or a family member have any of these symptoms, see your doctor immediately or go to the emergency room,” said Dr. Benin.

    For an appointment or more information about LaSalle Medical Associates, call 1-855-349-6019 or go online to LaSalleMedical.com.

    —30—

    About LaSalle Medical Associates

    LaSalle Medical Associates, Inc. is one of the largest independent and Latino-owned healthcare companies in Riverside and San Bernardino Counties. The corporate office is in Redlands.

    LaSalle is also an Independent Practice Association (IPA) of independently contracted doctors, hospitals, and clinics, delivering high-quality patient care to over 350,000 patients in Fresno, Kings, Los Angeles, Madera, Riverside, San Bernardino and Tulare counties.

     

    Save Your Life See Your Doctor—Regular Checkups Save Lives

    Malaika Jacocks gets her annual checkup from Dr. Rodriguez at the LaSalle Mt. Vernon Clinic in San Bernardino. The Centers for Disease Control (CDC) recommends annual or bi-annual check-ups allow your doctor to monitor your diagnostic readings (heart rate, blood pressure, etc.) and, if necessary, prescribe medication and/or treatment to bring these readings up to healthy levels.

    “Too many people stay away from a doctor’s office because they think if they feel okay, they don’t need to go in for an annual check-up. By the time they start to feel ill, they end up in the ER, and sometimes it’s just too late to save them,” said Dr. Albert Arteaga, CEO of LaSalle Medical Associates, Inc.

    SAN BERNARDINO, CAIF.   In addition to visiting a physician when an illness or injury occurs, the Centers for Disease Control (CDC) recommends annual or bi-annual check-ups that allow your doctor to monitor your diagnostic readings (heart rate, blood pressure, etc.) and, if necessary, prescribe medication and/or treatment to bring these readings up to healthy levels.

    According to the CDC, seven out of 10 U.S. deaths are caused by chronic disease. Roughly half of the country’s population has been diagnosed with a chronic illness, including heart disease, cancer, diabetes, AIDS, or other conditions classified by the medical community as preventable.

    Only 25.2 percent, or one in four people, report having a recent routine check-up. Yet, routine cardiovascular exams alone save tens of thousands of adult lives each year, while vaccines save the lives of roughly 42,000 children on an annual basis, according to the CDC.

    Annual or bi-annual preventive health screenings and primary care consultations have also been found to significantly increase life expectancy, particularly among the 30- to 49-year age group.

    “Too many people stay away from a doctor’s office because they think if they feel okay, they don’t need to go in for things like an annual check-up,” said Dr. Albert Arteaga, CEO of LaSalle Medical Associates, Inc. “And when illness strikes there is no established provider to treat and assist with the management of their needs.”

    Dr. Arteaga lost a sister to breast cancer. “My sister never opened up to tell either me or her older sister—both of us doctors—that she had a lump on her breast. Later we learned that she kept making excuses about it, ‘I bumped myself’ or ‘It’s just a bruise’ and she basically ignored it for over six months.”

    “There really is no reason for someone experiencing symptoms to put off seeing a doctor,” said Dr. Arteaga. Far more people today can obtain insurance thanks to Covered California, Medicaid and the like, making it much easier for them to get the care they need.

    “Health care is no longer an out-of-reach luxury for those who couldn’t afford insurance but is now available for everyone. Our staff are trained to help uninsured people who come to our offices to apply for coverage,” Dr. Arteaga said.

    In addition to providing acute care for people who may be coming down with something, Dr. Arteaga and his team make sure to reach out to those who are on longer-term care for a chronic condition like asthma or diabetes and get them to come in for regular checkups so that they do not suffer a relapse.

    For more information about LaSalle Medical Associates, Inc. call (855) 349-6019 or go online to LaSalleMedical.com.

    About LaSalle Medical Associates

    LaSalle Medical Associates, Inc. is one of the largest independent and Latino-owned healthcare companies in Riverside and San Bernardino Counties. The corporate office is in Redlands.

    LaSalle operates six clinics employing more than 100 dedicated healthcare professionals, treating children, adults, and seniors in San Bernardino and Riverside counties. LaSalle’s patients are primarily served by Medi-Cal and Healthy Families. LaSalle also accepts Blue Cross, Blue Shield, Molina, Care 1st, Health Net, and Inland Empire Health Plan (IEHP) coverage.

    LaSalle is also an Independent Practice Association (IPA) of independently contracted doctors, hospitals, and clinics, delivering high-quality patient care to approximately365,000 patients in Fresno, Kings, Los Angeles, Madera, Riverside, San Bernardino, San Joaquin, and Tulare counties.

    Every Wednesday is Covid 19 Vaccine Day for Kids

    cover shots

    April Reya a medical assistant, gives the COVID-19 vaccination shot to Vicki Creighton, of Riverside, Recently, at the LaSalle Medical Associates medical office located in Rialto, Calif. .

     

    “If it weren’t for the vaccine, I’m sure I would have ended up in the hospital,” said LaSalle Medical’s Compliance Officer, Barbara Graber.

     

    (REDLANDS, Calif.) “We started the second week of July, now every Wednesday is “Covid Vaccine Day for Kids,” says Dr. Albert Arteaga, pediatrician, and the CEO of LaSalle Medical Associates.

    “Now that Moderna has released its three variations on a Covid vaccine for younger people we are full speed ahead,” says Dr. Arteaga, “… we have been tracking the Covid 19 pandemic very closely and believe that the Moderna vaccine is the most effective option currently available.”

    LaSalle Medical’s Compliance Officer, Barbara Graber, notes that five of LaSalle’s six clinics are providing Wednesday shots for youngsters. “We started slowly,” says Graber, “… now we are increasing the number of Covid-19 vaccines given weekly. We’ve given 170 shots in the first two weeks of August and parents are responding to our targeted internal outreach program that urges them to bring in their children for their vaccine.”

    Graber says being proactive with outreach to clinic patients leads to more people getting the vaccine. “Our team is calling to ask parents to bring in their youngsters to get vaccinated. This makes prevention likely to be a lot more effective.”

    The three vaccines are for children aged 6 months to 5 years, 6 to 11 years, and 12 years and older. There is a four-week wait between first and second shots.

    Graber contracted Covid-19 herself and says, “If it weren’t for the vaccine, I’m sure I would have ended up in thehospital.” She had the two-shot regimen as well as two booster shots. “This vaccine has proven itself and is now an important addition to our tool kit to help people stay healthy, safe and out of the hospital.”

    Barbara Graber, manager of compliance and special projects at LaSalle Medical Associates, Inc.

    LaSalle Medical Associates, Inc., clinics accept Blue Cross, Blue Shield, Molina, Care 1st, Health Net, and Inland Empire Health Plan coverage, as well as Medicare Medi-Cal and cash.

    For more information about LaSalle Medical Associates, Inc. call the office closest to you: Fontana (909) 823-4454; San Bernardino 17th Street (909) 887-6494; San Bernardino Mt. Vernon Ave. (909) 884-9091; Rialto (855) 349-6019; Hesperia (760) 947-2161; and Victorville (855) 349-6019.

    About LaSalle Medical Associates

    LaSalle Medical Associates, Inc. is one of the largest, independent, and Latino-owned healthcare companies in Riverside and San Bernardino Counties. The corporate office is in Redlands.

    LaSalle operates six clinics employing more than 100 dedicated healthcare professionals, treating children, adults and seniors in San Bernardino and Riverside counties. LaSalle’s patients are primarily served by Medi-Cal and Healthy Families. LaSalle also accepts Blue Cross, Blue Shield, Molina, Care 1st, Health Net, and Inland Empire Health Plan (IEHP) coverage.

    LaSalle is also an Independent Practice Association (IPA) of independently contracted doctors, hospitals and clinics, delivering high quality patient care to approximately 365,000 patients in Fresno, Kings, Los Angeles, Madera, Riverside, San Bernardino, San Joaquin and Tulare counties.