CENTRELAKE MEDICAL GROUP, INC. (NPI# 1104293216) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104293216 |
| Entity Type | Organization |
| Organization Name | CENTRELAKE MEDICAL GROUP, INC. |
| Other Organization Name | CENTRELAKE IMAGING AND ONCOLOGY |
| Practice Address |
10226 Lakewood Blvd Downey CA 90241-2742 |
| Mailing Address |
3115 E Guasti Rd Ontario CA 91761-7853 |
| Practice Telephone | 5622877205 |
| Practice Fax Number | 9097864391 |
| Mailing Telephone | 9092427300 |
| Mailing Fax Number | 9097864391 |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2015-08-31 |
| Authorized Official Name | DR. ARVIND LAPSIWALA (OWNER) |
| Authorized Official Telephone | 9092427300 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QR0206X |
Clinic/Center Specialization: Radiology, Mammography |
282092 | CA | Ambulatory Health Care Facilities |
| N | 261QX0203X |
Clinic/Center Specialization: Oncology, Radiation |
282092 | CA | Ambulatory Health Care Facilities |
| Y | 261QR0200X |
Clinic/Center Specialization: Radiology |
282092 | CA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Centrelake Imaging and Oncology | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629636006 | Centrelake Medical Group, Inc. | Radiology | 5562 Philadelphia St Ste 100, Chino, CA 91710-2482 | 2019-05-31 |
| 1689800377 | Centrelake Medical Group, Inc. | Radiology | 1555 N Orange Grove Ave, Pomona, CA 91767-3811 | 2009-06-08 |
| 1639137938 | Centrelake Medical Group, Inc. | Clinic/Center | 3115 E Guasti Rd, Ontario, CA 91761-7853 | 2006-05-03 |
| Street Address |
10226 LAKEWOOD BLVD |
| City | DOWNEY |
| State | CA |
| Zip Code | 90241-2742 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164029005 | Adam Lyle Barnhardt | Counselor | 11500 Paramont Blvd., Downey, CA 90241 | 2020-10-05 |
| 1922630482 | Betzabeth Benitez Perez | Counselor | Scadp, 11500 Paramount Blvd., Downey, CA 90241 | 2020-02-12 |
| 1457858714 | Diane Padre-gozun | Student in an Organized Health Care Education/Training Program | 11500 Brookshire Ave, Gme Office, Downey, CA 90241 | 2018-04-12 |
| 1295233963 | Community Family Guidance Center | Community/Behavioral Health | 12330 Woodruff Ave, Downey, CA 90241 | 2018-01-29 |
| 1487167433 | Progressive Medical Associates | Health Maintenance Organization | 6611 Seville Avenue, Huntington Park, CA 90241 | 2017-11-13 |
| 1194236018 | Dental Office of Downey Inc. | Clinic/Center | 10917 Paramounth Blvd, Downey, CA 90241 | 2017-10-18 |
| 1376063933 | Sophea Tim | Pharmacist | 11525 Brookshire Avenue Suite 400, Downey, CA 90241 | 2017-06-26 |
| 1952835282 | Dr. Jose Flores D.d.s Inc. | Preferred Provider Organization | 11510 Downey Ave, Downey, CA 90241 | 2017-04-13 |
| 1053844043 | Stephen Nealon Berberich | Internal Medicine | 1544 Downey Ave, Downey, CA 90241 | 2017-04-06 |
| 1225424187 | Davis Huang | Internal Medicine | 11500 Brookshire Ave., Downey, CA 90241 | 2015-04-07 |
| Find all providers in zip 90241 | ||||
| Taxonomy Code | 261QR0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043376767 | United Medical Imaging Healthcare, Inc. | Clinic/Center | 11411 Brookshire Ave Ste 101, Downey, CA 90241-5008 | 2006-12-28 |
| 1013961630 | Advanced Cardiac Imaging Corporation | Clinic/Center | 12632 Bellflower Blvd, Downey, CA 90242-4812 | 2006-05-19 |
| 1548435126 | United Medical Radiology Network | Clinic/Center | 11411 Brookshire Ave, #101, Downey, CA 90241-5026 | 2008-04-24 |
| 1760572036 | United Medical Imaging Healthcare, Inc. | Clinic/Center | 11411 Brookshire Ave, Suite 101, Downey, CA 90241-5003 | 2006-10-14 |
| 1861593360 | Functional Restoration Medical Center, Inc | Clinic/Center | 11411 Brookshire Ave, Suite 101, Downey, CA 90241-5003 | 2006-09-26 |
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| 1720625742 | F&m Radiology Medical Center Inc | Clinic/Center | 17779 Ventura Blvd # 100, Encino, CA 91316-3717 | 2019-12-09 |
| 1982240321 | United Care Foundation | Clinic/Center | 2233 Watt Ave Ste 120, Sacramento, CA 95825-0569 | 2019-11-20 |
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| 1518502087 | Ishraf Corporation | Clinic/Center | 5720 Stoneridge Mall Rd Ste 288, Pleasanton, CA 94588-2830 | 2019-11-08 |
| 1780227769 | Drs Concepts, Incorporated | Clinic/Center | 9335 Reseda Blvd. Suite 102, Northridge, CA 91324 | 2019-10-23 |
| 1538700588 | Central Valley Medical Imaging, LLC | Clinic/Center | 1125 E Spruce Ave Ste 103, Fresno, CA 93720-3385 | 2019-10-01 |
| 1700447497 | Ester A Hanna | Clinic/Center | 72650 Fred Waring Dr Ste 107, Palm Desert, CA 92260-5007 | 2019-06-24 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.