Organization Active NPI

Covina Cancer Care Medical Center, Inc.

  • Specialist
  • Covina, CA
National Provider Identifier
1811927569
Registry record updated Feb 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
C50363 Issued in CA
Legal business name
COVINA CANCER CARE MEDICAL CENTER, INC.
Practice address
554 E San Bernardino Rd
Ste. 105
Covina, CA 91723-1747
Phone
(626) 331-6866
Fax
(626) 331-6773
NPI assigned
Jul 4, 2006
Last updated
Feb 21, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2020

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

Authorized official

Name
Amar Lapsi
Title
Chief of Operations
Phone
(626) 331-6866

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X C50363 CA Primary

Addresses

Primary practice location

554 E San Bernardino Rd
Ste. 105
Covina, CA 91723-1747

Mailing address

554 E San Bernardino Rd
Ste. 105
Covina, CA 91723-1747
Phone (626) 331-6866

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041006001462 CA Part B Supplier - Clinic/Group Practice 5991764839 Receives reassigned benefits from 3 practitioners
Practice locations: Covina, CA; Downey, CA; Ontario, CA; Pomona, CA; Victorville, CA

National Provider Directory

National Provider Directory

Locations

554 E San Bernardino Rd
Ste 105
Covina, CA 91723
Phone (626) 331-6866

10226 Lakewood Blvd
Apt B
Downey, CA 90241
Phone (562) 291-6580

1555 N Orange Grove Ave
Pomona, CA 91767
Phone (909) 242-7300

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582243200000",
    "number": "1811927569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "554 E SAN BERNARDINO RD",
            "address_2": "STE. 105",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917231747",
            "telephone_number": "626-331-6866",
            "fax_number": "626-331-6773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "554 E SAN BERNARDINO RD",
            "address_2": "STE. 105",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917231747",
            "telephone_number": "626-331-6866",
            "fax_number": "626-331-6773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVINA CANCER CARE MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2020-02-21",
        "certification_date": "2020-02-21",
        "status": "A",
        "authorized_official_last_name": "LAPSI",
        "authorized_official_first_name": "AMAR",
        "authorized_official_title_or_position": "CHIEF OF OPERATIONS",
        "authorized_official_telephone_number": "626-331-6866"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "C50363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2020; 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.