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SOUTHERN CALIFORNIA IMMEDIATE MEDICAL CENTER NPI 1205041290


NPI Information

NPI: 1205041290
Provider Name: SOUTHERN CALIFORNIA IMMEDIATE MEDICAL CENTER
Classification: Specialist - 174400000X
Entity Type: Organization

CLIA Number: 05D1022709

Address:
15330 VALLEY VIEW AVE STE 1
LA MIRADA, CA
ZIP 90638
Phone: (562) 802-0208
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SOUTHERN CALIFORNIA IMMEDIATE MEDICAL CENTER is a specialist in La Mirada, CA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. SOUTHERN CALIFORNIA IMMEDIATE MEDICAL CENTER NPI is 1205041290. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

15330 VALLEY VIEW AVE STE 1
LA MIRADA, CA
ZIP 90638-238
Phone: (562) 802-0208
Fax: (562) 802-0999

The provider's authorized official is Thonas Roccapalumbo .
The authorized official title is Medical Director and has the following contact phone number (323) 726-3212.

The CLIA number assigned to this NPI record is 05D1022709 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/11/2007 and was last updated on 8/22/2020.


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
1174400000XSpecialist20 A5386CALIFORNIAYes

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.