NPIMap

Organization Active NPI

Southern California Health & Rehabilitation Program

  • Community/Behavioral Health Agency
  • Lynwood, CA
National Provider Identifier
1467775221
Registry record updated Jul 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
SOUTHERN CALIFORNIA HEALTH & REHABILITATION PROGRAM
Practice address
2610 Industry Way
Suite a
Lynwood, CA 90262-4283
Phone
(310) 631-8004
Fax
(310) 631-7830
NPI assigned
Mar 9, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2023

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

Authorized official

Name
Dr. Jack M Barbour, MDNPI 1568482792
Title
Ceo/President
Phone
(310) 631-8004

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
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

2610 Industry Way
Suite a
Lynwood, CA 90262-4283

Mailing address

2610 Industry Way
Suite a
Lynwood, CA 90262-4283
Phone (310) 631-8004

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101020000381 CA Part B Supplier - Other 4284827445 Receives reassigned benefits from 5 practitioners
8 other NPIs on this enrollment
Practice locations: Lynwood, CA; Los Angeles, CA

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Scharp Bellflower3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

7410 S Broadway
Los Angeles, CA 90003
Phone (323) 541-9016

3320 W Adams Blvd
Los Angeles, CA 90018
Phone (323) 596-2480

5201 S Vermont Ave
Los Angeles, CA 90037
Phone (323) 751-2677

2594 Industry Way
Lynwood, CA 90262
Phone (310) 667-4070

2620 Industry Way
Ste B
Lynwood, CA 90262
Phone (310) 667-4070

2610 Industry Way
Ste A
Lynwood, CA 90262
Phone (310) 537-9780

3741 Stocker St
Ste 207
View Park, CA 90008
Phone (323) 596-2480

Practitioners & affiliated clinicians

Practitioners 504

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

View all 504

NPI Registry JSON

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

{
    "created_epoch": "1268092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690243200000",
    "number": "1467775221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2610 INDUSTRY WAY",
            "address_2": "SUITE A",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902624283",
            "telephone_number": "310-631-8004",
            "fax_number": "310-631-7830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2610 INDUSTRY WAY",
            "address_2": "SUITE A",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902624283",
            "telephone_number": "310-631-8004",
            "fax_number": "310-631-7830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CALIFORNIA HEALTH & REHABILITATION PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-09",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A",
        "authorized_official_last_name": "BARBOUR",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "310-631-8004",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynwood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.