Superclinic Professionals Medical Corp a California Corporation

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

SUPERCLINIC PROFESSIONALS MEDICAL CORP A CALIFORNIA CORPORATION

Practice address

12134 Victory Blvd
North Hollywood, CA 91606-3205

Phone

(818) 762-8702

Fax

(818) 761-2583

NPI assigned

Aug 22, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Mitchell Paul Rubin

Title

Administrator

Phone

(818) 762-8702

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Vahe T Azizian, MD

  • Gynecology Physician
  • Simi Valley, CA
  • NPI 1457414658
  Medicare reassignment Care Compare group NPD
• Herman B Bell, D.O.

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1588789218
  Medicare reassignment Care Compare group NPD
• Hossein Dehghani, M.D.

  • Interventional Cardiology Physician
  • Glendale, CA
  • NPI 1316156797
  Medicare reassignment Care Compare group NPD
• Elika Derek, M.D.

  • Surgery Physician
  • Los Angeles, CA
  • NPI 1427280510
  Medicare reassignment Care Compare group NPD
• Harout Dermendjian, M.D.

  • Vascular & Interventional Radiology Physician
  • Valencia, CA
  • NPI 1689038424
  Medicare reassignment Care Compare group NPD
• Alejandro Esteban Gil, M.D.

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1417951963
  Medicare reassignment Care Compare group NPD
• John James Kowalczyk, DO

  • Urology Physician
  • Los Angeles, CA
  • NPI 1548254089
  Medicare reassignment Care Compare group NPD
• Archie R Mays, M.D.

  • General Practice Physician
  • Long Beach, CA
  • NPI 1568414886
  Medicare reassignment Care Compare group NPD
• Aron L Rotman, M.D.

  • Internal Medicine Physician
  • Valley Village, CA
  • NPI 1508900887
  Medicare reassignment Care Compare group NPD
• Georges Tanbe, M.D.

  • Interventional Cardiology Physician
  • Sherman Oaks, CA
  • NPI 1679733646
  Medicare reassignment Care Compare group
• Robin Zakariaei, M.D.

  • Internal Medicine Physician
  • Encino, CA
  • NPI 1457509259
  Medicare reassignment Care Compare group
• John E Bohm, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Calexico, CA
  • NPI 1992771604
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1503360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1326564212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12134 VICTORY BLVD",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916063205",
            "telephone_number": "818-762-8702",
            "fax_number": "818-761-2583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12134 VICTORY BLVD",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916063205",
            "telephone_number": "818-762-8702",
            "fax_number": "818-761-2583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPERCLINIC PROFESSIONALS MEDICAL CORP A CALIFORNIA CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-22",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "RUBIN",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "818-762-8702",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chanelstephanie Suniga
• Sunrise Home Health Inc
• Sunshine RX
• Sunshine Speech Services
• Super Lab Diagnostics Inc
• Superior Care Hospice Inc
• Superior Hearing Solutions (Miracle Ear)
• Superior Home Health Care
• Superior Medical Transportation Inc (Superior Medical Transportation)
• Superior Pharmacy Inc (Superior Pharmacy II)

• Multi-Specialty Clinic/Center in North Hollywood, CA
• Providers in North Hollywood, CA by specialty
• Multi-Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.