Healthcare Provider Details

I. General information

NPI: 1649126251
Provider Name (Legal Business Name): FIRST PLACE PEDIATRICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2026
Last Update Date: 03/06/2026
Certification Date: 03/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2934 E GARVEY AVE S STE 210
WEST COVINA CA
91791-2178
US

IV. Provider business mailing address

2934 E GARVEY AVE S STE 210
WEST COVINA CA
91791-2178
US

V. Phone/Fax

Practice location:
  • Phone: 626-966-2545
  • Fax: 626-966-2547
Mailing address:
  • Phone: 626-966-2545
  • Fax: 626-966-2547

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: KELLY LOUISE MCMULLEN
Title or Position: DIRECTOR OF M&A AND INTEGRATION
Credential:
Phone: 903-466-1600