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FAIRWAY CHILDREN'S MEDICAL GROUP
NPI 1700510898
Pediatrics in West Covina, CA

Active since July 13, 2022CLIA Certified · 2 labs
2707 E VALLEY BLVD STE 215, WEST COVINA, CA 91792(909) 594-3382(626) 667-7633 Get Directions Write a Review

NPPES record last updated: April 23, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 6, 2023, Jul 13, 2022 (2 updates tracked since 2022).

About Fairway Children's Medical Group NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FAIRWAY CHILDREN'S MEDICAL GROUP (NPI 1700510898) is a healthcare organization registered as a pediatrics in West Covina, California and active in the NPI registry since July 2022. The organization holds 2 active CLIA laboratory certificates, maintains a secondary practice location in Diamond Bar, and lists Jackyln Chan, Owner, as its authorized official.

NPPES Registry Identity

NPI1700510898
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameFAIRWAY CHILDREN'S MEDICAL GROUP
Location Address2707 E VALLEY BLVD STE 215West Covina, CA 91792-3197
Mailing Address888 Brea Canyon Rd Ste 330Diamond Bar, CA 91789-3095 · (909) 594-3382 · Fax (626) 667-7633
Phone(909) 594-3382
Fax(626) 667-7633
Organization SubpartNo
Authorized OfficialJackyln ChanOwner · (909) 630-8762
Enumeration DateJuly 13, 2022
Last NPPES UpdateApril 23, 20252 updates tracked since enumeration
NPPES CertifiedApril 23, 2025
✔ NPI 1700510898 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
2707 E VALLEY BLVD STE 215, West Covina, CA 91792
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Secondary Practice Location 1

Location 1888 Brea Canyon Rd Ste 330Diamond Bar, CA 91789-3095 · Phone (909) 594-3382 · Fax (626) 667-7633

Other Identifiers 2

Other1447544333CA · Individual Type 1 Npi
OtherA130711CA · Ca Md State License #

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D0720261

Fairway Children's Medical Group Laboratory · West Covina, CA
Active · expires Aug 31, 2026
CLIA Number05D0720261
Laboratory TypePhysician Office
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorEva Y. Chan
Laboratory Phone(909) 594-3382
Laboratory LocationFairway Children's Medical Group Laboratory2707 E. Valley Blvd, Ste 215, West Covina, CA 91792
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 05D2305139

Fairway Children's Medical Group Laboratory · Diamond Bar, CA
Active · expires May 23, 2028
CLIA Number05D2305139
Laboratory TypePhysician Office
Certificate Effective DateMay 24, 2026
Certificate Expiration DateMay 23, 2028
Laboratory DirectorJackyln W. Chan
Laboratory Phone(909) 594-3382
Laboratory LocationFairway Children's Medical Group Laboratory888 S Brea Canyon Rd Ste 330, Diamond Bar, CA 91789
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JACKYLN WAI-SHAN CHAN M.D.
Pediatrics
2707 E VALLEY BLVD STE 215
WEST COVINA, CA 91792
Los Angeles County (909) 594-3382
DR. EVA Y CHAN M.D.
Pediatrics
2707 E VALLEY BLVD STE 215
WEST COVINA, CA 91792
Los Angeles County (909) 594-3382

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fairway Children's Medical Group's NPI number?

The NPI number for Fairway Children's Medical Group is 1700510898. It was assigned to this organization in the NPPES registry on July 13, 2022.

Where is Fairway Children's Medical Group located?

Fairway Children's Medical Group is located at 2707 E Valley Blvd Ste 215, West Covina, CA 91792. The listed phone number is (909) 594-3382.

What is Fairway Children's Medical Group's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Fairway Children's Medical Group hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Fairway Children's Medical Group was last updated on April 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.