La Verne Family Medical Center Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A50496 Issued in CA

Legal business name

LA VERNE FAMILY MEDICAL CENTER INC

Practice address

2100 Foothill Blvd
Suite a
La Verne, CA 91750-2905

Phone

(909) 596-1941

Fax

(909) 596-1943

NPI assigned

Aug 27, 2006

Last updated

Dec 9, 2011By 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

Tan Lin Wong, MDNPI 1790728749

Title

President

Phone

(909) 596-1941

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 3

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.

• Tan Lin Wong, MD

  • Internal Medicine Physician
  • La Verne, CA
  • NPI 1790728749
  Medicare reassignment NPD Authorized official
• May Thet Nwe, M.D.

  • Family Medicine Physician
  • El Monte, CA
  • NPI 1407019649
  NPD (past)
• Li Chiung Wong, MD

  • Pediatrics Physician
  • West Covina, CA
  • NPI 1841392032
  NPD (past)

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

{
    "created_epoch": "1156636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323388800000",
    "number": "1457469884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 FOOTHILL BLVD",
            "address_2": "SUITE A",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917502905",
            "telephone_number": "909-596-1941",
            "fax_number": "909-596-1943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 FOOTHILL BLVD",
            "address_2": "SUITE A",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917502905",
            "telephone_number": "909-596-1941",
            "fax_number": "909-596-1943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA VERNE FAMILY MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-27",
        "last_updated": "2011-12-09",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "TAN",
        "authorized_official_middle_name": "LIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-596-1941",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A50496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP ID",
            "identifier": "W20443",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cheryl Lee Kroll, BS
• Jeffrey Kropf, PH.D.
• Cassandra Ilene La Vallie
• La Verne Acupuncture, PC
• La Verne Family Chiropractic
• La Verne Medical Equipment, Inc.
• La Verne Modern Dentistry, Prof. Corp. (La Verne Modern Dentistry)
• Brittney Michelle Lagrave
• Surya Kanti Lakhanpal, M.D.
• Alicia Landa, LMFT

• Family Medicine Physician in La Verne, CA
• Providers in La Verne, 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 Dec 9, 2011; 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.