CENTRELAKE MEDICAL GROUP INC
CENTRELAKE MEDICAL GROUP INC is an organization registered with the National Plan and Provider Enumeration System (NPPES) under NPI 1760721112, based in West Covina, CA. It is classified under Radiology Clinic/Center.
Getting there
The practice address on file is 1700 W WEST COVINA PKWY, West Covina, CA 91790. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| FNP34299 | CA | Radiology Clinic/Center primary |
This provider holds licence FNP34299 issued in CA. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.
- Status
- Approved
- Provider type
- Part B Supplier - Independent Diagnostic Testing Facility (idtf)
- PAC ID
- 1658471123
Enrolled in Medicare 2 times, across 1 state:
| State | Enrollment ID | Provider type |
|---|---|---|
| California | O20140123001266 | Part B Supplier - Independent Diagnostic Testing Facility (idtf) |
| California | O20140307000376 | Part B Supplier - Clinic/group Practice |
Medicare enrolment is recorded as approved under the provider type Part B Supplier - Independent Diagnostic Testing Facility (idtf). There are 2 separate enrolment records. Multiple enrolments usually mean the provider bills Medicare from more than one practice location, or has kept an earlier enrolment after moving. Each record carries its own enrolment ID, listed above. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
What Radiology covers
Definition to come... NUCC Health Care Provider Taxonomy, code 261QR0200X
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-2 identifies an organization — a clinic, hospital, group practice, laboratory, or supplier. Individual clinicians working there hold their own NPI-1 numbers separately, so a bill may reference both.
| NPI | 1760721112 valid check digit |
|---|---|
| Entity type | Organization (NPI-2) |
| Enumeration date | Feb 5, 2013 |
| Last updated | May 24, 2021 |
| Status | Active |
| Practice address |
1700 W WEST COVINA PKWY West Covina, CA 91790 (909) 242-7300 Fax (909) 784-3760 |
| Mailing address |
3115 E GUASTI RD Ontario, CA 91761 |
| Other names |
Centrelake Imaging & Oncology Former Legal Name |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 7 | 6 | 0 | 7 | 2 | 1 | 1 | 1 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 7 | 3 | 0 | 5 | 2 | 2 | 1 | 2 |
Sum = 48 · next multiple of 10 = 50 · check digit = 2 · actual last digit = 2
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.