La Providencia Ipa, Inc.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

56374 Issued in CA

Legal business name

LA PROVIDENCIA IPA, INC.

Practice address

14342 Ramona Blvd
Baldwin Park, CA 91706-3241

Phone

(562) 463-0172

NPI assigned

Aug 2, 2017

Organization subpart

No

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

Authorized official

Name

Samuel Wosk

Title

Secretary

Phone

(562) 463-0172

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1501632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508976000000",
    "number": "1760906507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14342 RAMONA BLVD",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917063241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14342 RAMONA BLVD",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917063241",
            "telephone_number": "562-463-0172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA PROVIDENCIA IPA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-02",
        "last_updated": "2017-10-26",
        "status": "A",
        "authorized_official_last_name": "WOSK",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "562-463-0172"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "71133",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "45086",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "56374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yu-Chien Kuo, MD
• Syna M. Kuttothara, M.D.
• Won C Kwak, PHARM D.
• Esther Yeajin Kwon, M.D
• Hla H. Kyi, MD
• Susan La, PHARMD
• Jennifer A Lacson-Wong, OD
• Charles Lam
• Kar Kei Claire Lam
• Linh Lam

• Internal Medicine Physician in Baldwin Park, CA
• Providers in Baldwin Park, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2017; 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.