West Covina Medical Clinic

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

WEST COVINA MEDICAL CLINIC

Doing business as

West Covina Medical Group

Practice address

1500 W West Covina Pkwy
West Covina, CA 91790-2707

Phone

(626) 960-8614

Fax

(626) 960-9177

NPI assigned

Feb 20, 2007

Last updated

Feb 21, 2008By 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

Kerry Weiner, M.D.NPI 1528062437

Title

President

Phone

(818) 637-2000

Specialties & licenses 5

Addresses

Other identifiers 2

Other names 1

• West Covina Medical Group Doing business as

Locations

Practitioners 1

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.

• Kerry E Weiner, M.D.

  • Gastroenterology Physician
  • Burbank, CA
  • NPI 1528062437
  NPD Authorized official

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203552000000",
    "number": "1386789311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 FLOWER ST STE A",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912013000",
            "telephone_number": "818-637-2000",
            "fax_number": "818-242-8761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 W WEST COVINA PKWY",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917902707",
            "telephone_number": "626-960-8614",
            "fax_number": "626-960-9177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST COVINA MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2008-02-21",
        "status": "A",
        "authorized_official_last_name": "WEINER",
        "authorized_official_first_name": "KERRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-637-2000",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE SUPPLIER",
            "identifier": "1101890001",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0105950",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Covina Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• West Covina Home Health Care LLC
• West Covina Medical Center
• West Covina Medical Center Inc (West Covina Medical Center Pharmacy)
• West Covina Medical Center, Inc.
• West Covina Medical Center, Inc.
• West Covina Medical Group, Inc.
• West Covina Unified School District
• Western Dental Services, Inc.
• Western United Medical Care Inc.
• Michael Whisenand

• Family Medicine Physician in West Covina, CA
• Providers in West Covina, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2008; 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.