Cornell Wells Jr., M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A131635 Issued in CA

Practice address

1511 W Garvey Ave N
West Covina, CA 91790-2138

Phone

(626) 960-4844

NPI assigned

Apr 13, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Cornell Wells Jr. Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1334275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473206400000",
    "number": "1851658850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1511 W GARVEY AVE N",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917902138",
            "telephone_number": "626-960-4844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 W GARVEY AVE N",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917902138",
            "telephone_number": "626-960-4844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "CORNELL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-13",
        "last_updated": "2016-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A131635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CORNELL",
            "last_name": "WELLS",
            "prefix": "MR.",
            "suffix": "JR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Omar Waziri, PA-C
• Fernando Eduardo Weaver
• Jaela Weaver
• Jillian Weir
• Well Wise Hospice
• Mark Wei Weng, D.O.
• Nicole Werdesheim, M.S. BCBA
• Wescove Laboratory Inc.
• West Covina Adult Day Services, Inc. (Cameron Adult Day Health Care Center)
• West Covina Care, Inc. (Beacon Healthcare Center)

• Psychiatry Physician in West Covina, CA
• Providers in West Covina, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2016; 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.

Verify at the official NPI Registry.