Pinpin Priswaldy Tedja-yen, NP | |
420 S Glendora Ave, West Covina, CA 91790-3001 | |
(626) 919-4333 | |
Not Available |
Full Name | Pinpin Priswaldy Tedja-yen |
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Gender | Female |
Speciality | Registered Nurse |
Location | 420 S Glendora Ave, West Covina, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1114290178 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
163W00000X | Registered Nurse | 682814 (California) | Primary |
Entity Name | Southern California Permanente Medical Group |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1770515280 PECOS PAC ID: 6002729175 Enrollment ID: O20031110000678 |
Entity Name | Southern California Permanente Medical Group |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1316979834 PECOS PAC ID: 6002729175 Enrollment ID: O20040126000823 |
Entity Name | East Valley Community Health Center, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1831243625 PECOS PAC ID: 9234041765 Enrollment ID: O20050425000560 |
Mailing Address | Practice Location Address |
---|---|
Pinpin Priswaldy Tedja-yen, NP 22910 Mountain Laurel Way, Diamond Bar, CA 91765-2530 Ph: (909) 895-9799 | Pinpin Priswaldy Tedja-yen, NP 420 S Glendora Ave, West Covina, CA 91790-3001 Ph: (626) 919-4333 |
Catharine Irene Jordan, REGISTERED NURSE Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 1115 S Sunset Ave, West Covina, CA 91790 Phone: 626-814-2534 Fax: 626-814-2591 | |
Michelle Inga, Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 1115 S Sunset Ave, West Covina, CA 91790 Phone: 626-962-4011 | |
Derek Tang, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 1628 S Conlon Ave, West Covina, CA 91790 Phone: 626-373-4532 | |
Kelly Hauser, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 1115 S Sunset Ave, West Covina, CA 91790 Phone: 606-814-2585 | |
Hester Gunadi, Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 216 S Myrtlewood St, West Covina, CA 91791 Phone: 714-686-5590 | |
Angelia Ive Decierdo Gonzalaes, Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 1115 S Sunset Ave, West Covina, CA 91790 Phone: 626-962-4011 |