MEDICARE: DR. JOSE R. PILPA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	A41431	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	A41431	OTHER	CA	MEDICAL LICENSE

General Provider Information

NPI Number	:	1760439012
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSE R. PILPA MD

Provider Business Mailing Address
First Line	:	818 W CAMERON AVE
Second Line	:
City	:	WEST COVINA
State	:	CA
Zip	:	91790-4136
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1433 W MERCED AVE STE 112
Second Line	:
City	:	WEST COVINA
State	:	CA
Zip	:	91790-3402
Country	:	US
Telephone Number	:	626-473-0320
Fax Number	:	626-473-0324

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/30/2006
Last Update Date	:	03/24/2022

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