Active NPI
Rachel Christine Tambunan, DDS
- Dentist
- West Covina, CA
National Provider Identifier
1629410550
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2901021065
- Practice address
- 1000 Lakes Dr Ste 405
West Covina, CA 91790-2927 - Phone
- (626) 489-3488
- Fax
- (626) 489-3489
- NPI assigned
- Jul 19, 2013
- Last updated
- Jan 23, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2901021065 | MI | Primary |
Addresses
Primary practice location
1000 Lakes Dr Ste 405
West Covina, CA 91790-2927
Mailing address
1000 Lakes Dr Ste 405
West Covina, CA 91790-2927
Phone (626) 489-3488
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160609002395 | CA | Order and Referring Only - Dentist | 2668762238 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901021065 | MI | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alvin Chu DDS, Inc | Current | Accepting new patients |
Locations
1000 Lakes Dr
Ste 405
West Covina, CA 91790
Phone (626) 489-3488
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1374192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705968000000",
"number": "1629410550",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 LAKES DR STE 405",
"city": "WEST COVINA",
"state": "CA",
"postal_code": "917902927",
"telephone_number": "626-489-3488",
"fax_number": "626-489-3489"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 LAKES DR STE 405",
"city": "WEST COVINA",
"state": "CA",
"postal_code": "917902927",
"telephone_number": "626-489-3488",
"fax_number": "626-489-3489"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAMBUNAN",
"first_name": "RACHEL",
"middle_name": "CHRISTINE",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-07-19",
"last_updated": "2024-01-23",
"certification_date": "2024-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901021065",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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 Jan 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.