Organization Active NPI

Mayflower Medical Group, Inc.

  • Internal Medicine Physician
  • West Covina, CA
National Provider Identifier
1003188160
Registry record updated Apr 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MAYFLOWER MEDICAL GROUP, INC.
Practice address
140 N Orange Ave.
Suite 100
West Covina, CA 91790-2032
Phone
(626) 800-1200
Fax
(626) 962-2471
NPI assigned
Feb 6, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Erica Carbajal
Title
Site Manager
Phone
(626) 800-1200

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X

Addresses

Primary practice location

140 N Orange Ave.
Suite 100
West Covina, CA 91790-2032

Mailing address

140 N Orange Ave Ste 100
West Covina, CA 91790-2032
Phone (626) 800-1200

Other practice location 1

1900 E La Palma Ave Ste A&b
Anaheim, CA 92805-1647
Phone (714) 888-5742

Other practice location 2

11436 Garvey Ave Ste A&b
El Monte, CA 91732-3304
Phone (626) 459-5420

Other identifiers 1

IdentifierTypeStateIssuer
6409040MedicaidCA

Other names 1

  • Mayflower Medical Group, Inc. Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061120000235 CA Part B Supplier - Clinic/Group Practice 6901804350 Receives reassigned benefits from 9 practitioners
1 other NPI on this enrollment
Practice locations: Anaheim, CA; Covina, CA; El Monte, CA; La Puente, CA; West Covina, CA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2041490Mayflower Medical Group Inc140 N Orange Ave Ste 100, West Covina, CA 91790Certificate of waiverMay 22, 2028
05D2088161Mayflower Medical Group Inc140 N Orange Ave Ste 104, West Covina, CA 91790Certificate of waiverDec 10, 2026
05D2137082Mayflower Medical Group, Inc140 North Orange Avenue, Suite 100, West Covina, CA 91790Certificate of waiverSep 19, 2027
05D2220550Mayflower Medical Group, Inc.1900 E la Palma Ave Ste a, Anaheim, CA 92805Certificate of waiverApr 12, 2027

National Provider Directory

National Provider Directory

Locations

1900 E La Palma Ave
Ste B
Anaheim, CA 92805
Phone (626) 800-1200

1900 E La Palma Ave
Ste A
Anaheim, CA 92805

1433 N Hollenbeck Ave
Covina, CA 91722
Phone (626) 214-1260

11436 Garvey Ave
Ste B
El Monte, CA 91732

11436 Garvey Ave
Ste Ab
El Monte, CA 91732
Phone (626) 459-5420

1840 N Hacienda Blvd
La Puente, CA 91744

140 N Orange Ave
Ste 10010
West Covina, CA 91790

140 N Orange Ave
Ste 101
West Covina, CA 91790

140 N Orange Ave
Ste 104
West Covina, CA 91790
Phone (626) 800-1200

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 26

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1328486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776902400000",
    "number": "1003188160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 N ORANGE AVE STE 100",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917902032",
            "telephone_number": "626-800-1200",
            "fax_number": "626-962-2471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 N ORANGE AVE.",
            "address_2": "SUITE 100",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917902032",
            "telephone_number": "626-800-1200",
            "fax_number": "626-962-2471"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1900 E La Palma Ave Ste A&b",
            "address_purpose": "LOCATION",
            "city": "Anaheim",
            "state": "CA",
            "postal_code": "928051647",
            "country_code": "US",
            "telephone_number": "714-888-5742",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11436 Garvey Ave Ste A&b",
            "address_purpose": "LOCATION",
            "city": "El Monte",
            "state": "CA",
            "postal_code": "917323304",
            "country_code": "US",
            "telephone_number": "626-459-5420",
            "fax_number": "626-444-4511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MAYFLOWER MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-06",
        "last_updated": "2026-04-23",
        "certification_date": "2026-04-23",
        "status": "A",
        "authorized_official_last_name": "CARBAJAL",
        "authorized_official_first_name": "ERICA",
        "authorized_official_title_or_position": "SITE MANAGER",
        "authorized_official_telephone_number": "626-800-1200"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6409040",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mayflower Medical Group, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.