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General NPI Number Information
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NPI Number | 1972498145
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Entity Type | Organization
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Legal Business Name | INTEGRAL HEALTH CLINIC WEST COVINA
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Dates
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Enumeration Date | 06/10/2025
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Last Update Date | 02/19/2026
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Provider Practice Location Address
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Address Line | 855 N LARK ELLEN AVE STE L
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City | WEST COVINA
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State | CA
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Zip | 91791-1099
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Country | US
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Telephone | 626-485-3620
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Fax |
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Provider Business Mailing Address
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Address Line | 855 N LARK ELLEN AVE STE L
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City | WEST COVINA
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State | CA
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Zip | 91791-1099
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Country | US
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Telephone | 626-485-3620
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | LUIS GARCIA-AYALA
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Credential | MD
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Telephone | 626-322-9779
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number |
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License Number State |
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