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SOUTHERN CALIFORNIA PRIMARY MEDICAL INC NPI 1043508559


NPI Information

NPI: 1043508559
Provider Name: SOUTHERN CALIFORNIA PRIMARY MEDICAL INC
Classification: Family Medicine - 207QG0300X
Entity Type: Organization

Specialization: Geriatric Medicine

CLIA Number: 05D2030474

Address:
19341 BEAR VALLEY RD STE 101
APPLE VALLEY, CA
ZIP 92308
Phone: (760) 810-7778
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SOUTHERN CALIFORNIA PRIMARY MEDICAL INC is a geriatric medicine family medicine in Apple Valley, CA. The provider is a family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. SOUTHERN CALIFORNIA PRIMARY MEDICAL INC NPI is 1043508559. The provider is registered as an organization entity type.

The provider's business location address is:

19341 BEAR VALLEY RD STE 101
APPLE VALLEY, CA
ZIP 92308
Phone: (760) 810-7778
Fax: (760) 810-7780

The provider's authorized official is Ashish Malhotra .
The authorized official title is Owner and has the following contact phone number (760) 810-7778.

The CLIA number assigned to this NPI record is 05D2030474 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/18/2011 and was last updated on 8/6/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QP2300XClinic/CenterPrimary CareA91216CALIFORNIANo
2207QG0300XFamily MedicineGeriatric MedicineA91216CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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