NPIMap

Organization Active NPI

Centrelake Medical Group, Inc.

  • Radiology Clinic/Center
  • Downey, CA
National Provider Identifier
1104293216
Registry record updated May 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
License
282092 Issued in CA
Legal business name
CENTRELAKE MEDICAL GROUP, INC.
Practice address
10226 Lakewood Blvd
Downey, CA 90241-2742
Phone
(562) 287-7205
Fax
(909) 786-4391
NPI assigned
Aug 24, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2021

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

Authorized official

Name
Dr. Arvind Lapsiwala, M.D.
Title
Owner
Phone
(909) 242-7300

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X 282092 CA Primary
Mammography Clinic/Center 261QR0206X 282092 CA
Radiation Oncology Clinic/Center 261QX0203X 282092 CA

Addresses

Primary practice location

10226 Lakewood Blvd
Downey, CA 90241-2742

Mailing address

3115 E Guasti Rd
Ontario, CA 91761-7853
Phone (909) 242-7300

Other names 1

  • Centrelake Imaging and Oncology Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151231001557 CA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 1658471123 Practice locations: Downey, CA

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Centrelake Imaging Oncolog10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 11

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

NPI Registry JSON

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

{
    "created_epoch": "1440374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621814400000",
    "number": "1104293216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3115 E GUASTI RD",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917617853",
            "telephone_number": "909-242-7300",
            "fax_number": "909-786-4391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10226 LAKEWOOD BLVD",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902412742",
            "telephone_number": "562-287-7205",
            "fax_number": "909-786-4391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRELAKE MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-24",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A",
        "authorized_official_last_name": "LAPSIWALA",
        "authorized_official_first_name": "ARVIND",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-242-7300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "CA",
            "license": "282092",
            "primary": true
        },
        {
            "code": "261QR0206X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mammography",
            "state": "CA",
            "license": "282092",
            "primary": false
        },
        {
            "code": "261QX0203X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oncology, Radiation",
            "state": "CA",
            "license": "282092",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Centrelake Imaging and Oncology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Downey, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.