Organization Active NPI

Southern California Doctors Prof Medical Corp

  • Urgent Care Clinic/Center
  • Anaheim, CA
National Provider Identifier
1396259149
Registry record updated Oct 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
License
A102841 Issued in CA
Legal business name
SOUTHERN CALIFORNIA DOCTORS PROF MEDICAL CORP
Practice address
710 S Brookhurst St Ste a
Anaheim, CA 92804-4321
Phone
(714) 494-1331
Fax
(714) 494-1332
NPI assigned
Nov 30, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2025

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

Authorized official

Name
Robby Ayoub, MDNPI 1396958237
Title
President
Phone
(714) 683-2970

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X A102841 CA Primary

Addresses

Primary practice location

710 S Brookhurst St Ste a
Anaheim, CA 92804-4321

Mailing address

710 S Brookhurst St Ste a
Anaheim, CA 92804-4321

Other identifiers 1

IdentifierTypeStateIssuer
1396958237MedicaidCA

Other names 1

  • So Cal Urgent Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180307000961 CA Part B Supplier - Clinic/Group Practice 7416218425 Practice locations: Anaheim, CA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2145198So Cal Urgent Care710 S Brookhurst St, Ste a, Anaheim, CA 92804Certificate of waiverMar 2, 2028

National Provider Directory

National Provider Directory

Locations

710 S Brookhurst St
Ste B
Anaheim, CA 92804

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1512000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759363200000",
    "number": "1396259149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 S BROOKHURST ST STE A",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928044321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 S BROOKHURST ST STE A",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928044321",
            "telephone_number": "714-494-1331",
            "fax_number": "714-494-1332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CALIFORNIA DOCTORS PROF MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-30",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A",
        "authorized_official_last_name": "AYOUB",
        "authorized_official_first_name": "ROBBY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-683-2970",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "CA",
            "license": "A102841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396958237",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "So Cal Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2025; 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.