Covina Ear Nose & Throat Medical Group Inc

Primary specialty

SpecialistTaxonomy code 174400000X

License

A48653 Issued in CA

Legal business name

COVINA EAR NOSE & THROAT MEDICAL GROUP INC

Practice address

202 W College St
Covina, CA 91723-1902

Phone

(626) 966-2111

Fax

(626) 967-6315

NPI assigned

Feb 2, 2007

Last updated

Sep 27, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. James Garner Williams, MDNPI 1316924608

Title

President

Phone

(626) 966-2111

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

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.

• James Garner Williams, MD

  • Otolaryngology Physician
  • Covina, CA
  • NPI 1316924608
  Medicare reassignment NPD Authorized official
• Erin Jessica Simms, MD

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Oakland, CA
  • NPI 1588735476
  NPD (past)

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601164800000",
    "number": "1255479192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 W COLLEGE ST",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917231902",
            "telephone_number": "626-966-2111",
            "fax_number": "626-967-6315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 W COLLEGE ST",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917231902",
            "telephone_number": "626-966-2111",
            "fax_number": "626-967-6315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVINA EAR NOSE & THROAT MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2020-09-27",
        "certification_date": "2020-09-27",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "GARNER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-966-2111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A48653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A486530",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melanie Aylin Covarrubias Pelayo
• Covina Cancer Care Medical Center, Inc.
• Covina Care Center, Inc. (Covina Rehabilitation Center)
• Covina Court Senior Living, LLC
• Covina Dermatology Center
• Covina Emergency Medical Group, Inc.
• Covina Eyecare Optometry Inc (Edwin Wu, O.D.)
• Covina Eyecare Optometry Inc. (Raymond Wu, O.D.)
• Covina Healthcare Inc (Rite Care Pharmacy)
• Covina Hearing Aid Center, Inc

• Specialist in Covina, CA
• Providers in Covina, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2020; 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.