Individual provider Active NPI

Lina C. Dela Cruz, MD

  • Internal Medicine Physician
  • West Covina, CA
National Provider Identifier
1952489858
Registry record updated Feb 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A69421 Issued in CA
Practice address
140 N Orange Ave Ste 100
West Covina, CA 91790-2032
Phone
(626) 800-1200
NPI assigned
Nov 1, 2006
Last updated
Feb 2, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A69421 CA Primary

Addresses

Primary practice location

140 N Orange Ave Ste 100
West Covina, CA 91790-2032

Mailing address

140 N Orange Ave Ste 100
West Covina, CA 91790-2032
Phone (626) 800-1200

Other identifiers 1

IdentifierTypeStateIssuer
00A694210MedicaidCA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110315000328 CA Practitioner - Internal MedicinePractitioner - General Practice 7012199821 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1989
Medicare assignment
May accept Medicare assignment
Group practices
Mayflower Medical Group IncGroup PAC ID 6901804350, 7 clinicians

Practice addresses (Care Compare)

140 N Orange Ave
Suite 100
West Covina, CA 91790-2032
Phone (626) 800-1200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mayflower Medical Group, Inc. Internal Medicine CurrentSince Mar 3, 2012 Accepting new patients

Locations

1433 N Hollenbeck Ave
Ste 200
Covina, CA 91722
Phone (626) 331-2209

140 N Orange Ave
Ste 100
West Covina, CA 91790
Phone (626) 800-1200

1535 W Merced Ave
Ste 104
West Covina, CA 91790
Phone (626) 337-7087

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 1

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643760000000",
    "number": "1952489858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 N ORANGE AVE STE 100",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917902032",
            "telephone_number": "626-800-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 N ORANGE AVE STE 100",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917902032",
            "telephone_number": "626-800-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELA CRUZ",
        "first_name": "LINA",
        "middle_name": "C.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A69421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A694210",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

Verify at the official NPI Registry.