Fairway Children'S Medical Group

LBN: Fairway Children'S Medical Group
Fairway Children'S Medical Group is an health care organization with primary practice located at 2707 E Valley Blvd Ste 215 , West Covina CA 91792-3197. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as the primary health care specialty. Fairway Children'S Medical Group can be contacted via phone (909) 594-3382, or through Chan, Jackyln via phone (909) 630-8762.

Contact Information

Primary practice address
2707 E Valley Blvd Ste 215 West Covina CA 91792-3197
Phone: (909) 594-3382
Fax: (626) 667-7633
Website:
Map and Directions
Authorized official contact:
Name: Chan, Jackyln Doctor of Medicine (MD)
Phone: (909) 630-8762

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X

Profile Details

NPI number 1700510898
LBN Legal business name Fairway Children'S Medical Group
DBA Doing business as
Authorized official Chan, Jackyln Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 13th, 2022
Last updated Sep 6th, 2023 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700510898 NPPES
California Other A130711 CA MD STATE LICENSE #
California Other 1447544333 CA MD STATE LICENSE #

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