Healthcare Provider Details

I. General information

NPI: 1174550487
Provider Name (Legal Business Name): SHARONDA PATRICE COVINGTON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15603 HAWTHORNE BLVD
LAWNDALE CA
90260-2639
US

IV. Provider business mailing address

PO BOX 661297
ARCADIA CA
91066-1297
US

V. Phone/Fax

Practice location:
  • Phone: 310-569-8746
  • Fax:
Mailing address:
  • Phone: 626-447-0296
  • Fax: 626-447-6057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA74271
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: