NPIMap

Organization Active NPI

Southern California Specialty Care, Inc.

  • General Practice Physician
  • La Mirada, CA
National Provider Identifier
1457583601
Registry record updated Aug 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
SOUTHERN CALIFORNIA SPECIALTY CARE, INC.
Practice address
14900 Imperial Hwy
La Mirada, CA 90638-2172
Phone
(562) 944-1900
Fax
(562) 906-3455
NPI assigned
Aug 20, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2009

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

Authorized official

Name
Mr. Mostafa Adam Darvish
Title
Executive Director
Phone
(714) 893-4541

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

14900 Imperial Hwy
La Mirada, CA 90638-2172

Mailing address

14900 Imperial Hwy
La Mirada, CA 90638-2172
Phone (562) 944-1900

Other identifiers 2

IdentifierTypeStateIssuer
ZZZB1919ZOtherBLUE CROSS
HSP32028FMedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Southern California Specialty Care Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1250726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250726400000",
    "number": "1457583601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14900 IMPERIAL HWY",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906382172",
            "telephone_number": "562-944-1900",
            "fax_number": "562-906-3455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14900 IMPERIAL HWY",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906382172",
            "telephone_number": "562-944-1900",
            "fax_number": "562-906-3455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CALIFORNIA SPECIALTY CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-20",
        "last_updated": "2009-08-20",
        "status": "A",
        "authorized_official_last_name": "DARVISH",
        "authorized_official_first_name": "MOSTAFA",
        "authorized_official_middle_name": "ADAM",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "714-893-4541",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "ZZZB1919Z",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSP32028F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mirada, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.