Covina Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

COVINA SURGERY CENTER, LLC

Practice address

246 W College St
Suite 200
Covina, CA 91723-1910

Phone

(626) 966-2222

Fax

(866) 398-7641

NPI assigned

Dec 29, 2008

Organization subpart

No

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

Authorized official

Name

Dr. John P Khalaf, DDS

Title

Director

Phone

(626) 966-2222

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Tax ID family

Covina Surgery Center Dental Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• John Khalaf DDS, Inc.

  dba covina surgery center dental group

  • Dental Clinic/Center
  • Covina, CA
  • NPI 1942466131
  NPD tax ID

Locations

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

{
    "created_epoch": "1230508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1230508800000",
    "number": "1811133663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 W COLLEGE ST",
            "address_2": "SUITE 200",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917231910",
            "telephone_number": "626-966-2222",
            "fax_number": "866-398-7641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 W COLLEGE ST",
            "address_2": "SUITE 200",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917231910",
            "telephone_number": "626-966-2222",
            "fax_number": "866-398-7641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVINA SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-29",
        "last_updated": "2008-12-29",
        "status": "A",
        "authorized_official_last_name": "KHALAF",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "626-966-2222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Covina Healthcare Inc (Rite Care Pharmacy)
• Covina Hearing Aid Center, Inc
• Covina Medical Supply Inc
• Covina Pharmacy Inc (Covina Pharmacy)
• Covina Surgery Center, LLC
• Covina-Valley Unified School District
• Angie Craig, RN
• Creative Dental Arts, Inc.
• Creative Passion Partners Inc.
• Davon Crenshaw

• Ambulatory Surgical Clinic/Center in Covina, CA
• Providers in Covina, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.