NPIMap

Organization Active NPI

Doctors Hospital of West Covina, Inc.

Doing business as Doctors Hospital of West Covina

  • Skilled Nursing Facility
  • West Covina, CA
National Provider Identifier
1013925072
Registry record updated Feb 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
930000188 Issued in CA
Legal business name
DOCTORS HOSPITAL OF WEST COVINA, INC.
Doing business as
Doctors Hospital of West Covina
Practice address
725 S Orange Ave
West Covina, CA 91790-2614
Phone
(626) 338-8481
Fax
(626) 960-9178
NPI assigned
Aug 4, 2006
Last updated
Feb 4, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2016

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

Authorized official

Name
Mr. Gerald H. Wallman
Title
Administrator
Phone
(626) 338-8481

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 930000188 CA Primary

Addresses

Primary practice location

725 S Orange Ave
West Covina, CA 91790-2614

Mailing address

725 S Orange Ave
West Covina, CA 91790-2614
Phone (626) 338-8481

Other identifiers 1

IdentifierTypeStateIssuer
LTC70089FMedicaidCA

Other names 1

  • Doctors Hospital of West Covina Doing business as

National Provider Directory

National Provider Directory

Locations

10816 Valley Blvd
El Monte, CA 91731
Phone (626) 401-2775

130 W Route 66
Ste 216
Glendora, CA 91740
Phone (626) 335-7800

Practitioners & affiliated clinicians

Practitioners 31

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454544000000",
    "number": "1013925072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 S ORANGE AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917902614",
            "telephone_number": "626-338-8481",
            "fax_number": "626-960-9178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 S ORANGE AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917902614",
            "telephone_number": "626-338-8481",
            "fax_number": "626-960-9178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCTORS HOSPITAL OF WEST COVINA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2016-02-04",
        "status": "A",
        "authorized_official_last_name": "WALLMAN",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "626-338-8481",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "930000188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC70089F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Doctors Hospital of West Covina",
            "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 Feb 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.