Healthcare Provider Details

I. General information

NPI: 1124027529
Provider Name (Legal Business Name): WEST COVINA PLAN IPA INC., A MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 06/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 E BADILLO ST SUITE 100
COVINA CA
91723-2846
US

IV. Provider business mailing address

605 E BADILLO ST SUITE 100
COVINA CA
91723-2846
US

V. Phone/Fax

Practice location:
  • Phone: 626-732-9882
  • Fax: 626-732-9617
Mailing address:
  • Phone: 626-732-9882
  • Fax: 626-732-9617

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ARVIND LAPSIWALA
Title or Position: PRESIDENT, MEDICAL DIRECTOR
Credential: M.D.
Phone: 626-732-9882