SOUTHERN CALIFORNIA MEDICAL CENTER INC. NPI 1821625872

NPI Information

  • NPI: 1821625872
  • Provider Name: SOUTHERN CALIFORNIA MEDICAL CENTER, INC.
  • Classification: Clinic/Center - 261QC1500X
  • Specialization: Community Health
  • Entity Type: Organization
  • CLIA Number: 05D2035037
  • Address: 502 W HOLT AVE
    POMONA, CA
    ZIP 91768
  • Phone: (909) 620-8500

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NPI Details

SOUTHERN CALIFORNIA MEDICAL CENTER, INC. is a community health clinic center in Pomona, CA. SOUTHERN CALIFORNIA MEDICAL CENTER, INC. NPI is 1821625872. The provider is registered as an organization entity type.

The provider's business location address is:

502 W HOLT AVE
POMONA, CA
ZIP 91768-604
Phone: (909) 620-8500
Fax: (909) 620-5799

The provider's authorized official is Ellie Zare .
The authorized official title is Sr. Program Manager and has the following contact phone number (818) 650-6700.

The CLIA number assigned to this NPI record is 05D2035037 - federally qualified health center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/26/2020 and was last updated on 6/13/2023.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1251S00000XCommunity/Behavioral HealthNo
2261Q00000XClinic/CenterNo
3261QD0000XClinic/CenterDentalNo
4261QF0050XClinic/CenterFamily Planning, Non-SurgicalNo
5261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)No
6261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)No
7261QR0206XClinic/CenterRadiology, MammographyNo
8261QC1500XClinic/CenterCommunity HealthYes

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: 3/30/2025

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