Individual provider Active NPI

Lauren Tatum, P.A

  • Medical Physician Assistant
  • Covina, CA
National Provider Identifier
1740601509
Registry record updated May 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
51263 Issued in CA
Practice address
420 W Rowland St
Covina, CA 91723-2943
Phone
(626) 331-6411
Fax
(626) 251-1559
NPI assigned
Dec 21, 2013
Last updated
May 4, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 51263 CA Primary

Addresses

Primary practice location

420 W Rowland St
Covina, CA 91723-2943

Mailing address

12942 Baltimore CT
Chino, CA 91710-5937

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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140513002249 CA Practitioner - Physician Assistant 9931322245 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Medical and Urgent Care CenterGroup PAC ID 5294927851, 9 clinicians

Practice addresses (Care Compare)

974 W Foothill Blvd
Upland, CA 91786-3728
Phone (909) 981-2273

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
51263CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Anaheim Urgent Care, Inc CurrentSince Dec 24, 2020 Accepting new patients
Anaheim Urgent Care, Inc CurrentSince Dec 24, 2020 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Jul 1, 2017 Accepting new patients
Advanced Medical and Urgent Care Center CurrentSince Aug 9, 2025 Accepting new patients
Anaheim Urgent Care, Inc. Current Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

831 S State College Blvd
Anaheim, CA 92806
Phone (714) 533-2273

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

420 W Rowland St
Covina, CA 91723
Phone (626) 331-6411

1300 N La Brea Ave
Los Angeles, CA 90028
Phone (323) 464-1336

5717 Melrose Ave
Los Angeles, CA 90038
Phone (323) 957-2273

888 S Figueroa St
Ste 600
Los Angeles, CA 90017

601 Torrance Blvd
#1182
Redondo Beach, CA 90277

974 W Foothill Blvd
Upland, CA 91786
Phone (909) 932-1122

Organizations & group practices 6

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": "1387584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462320000000",
    "number": "1740601509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12942 BALTIMORE CT",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917105937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W ROWLAND ST",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917232943",
            "telephone_number": "626-331-6411",
            "fax_number": "626-251-1559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATUM",
        "first_name": "LAUREN",
        "name_prefix": "Miss",
        "credential": "P.A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-21",
        "last_updated": "2016-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "51263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covina, CA

Sources for this page

Verify at the official NPI Registry.