Socal Medical, Inc

Primary specialty

Portable X-ray and/or Other Portable Diagnostic Imaging SupplierTaxonomy code 335V00000X

License

FAC69883 Issued in CA

Legal business name

SOCAL MEDICAL, INC

Practice address

12850 Crawford Dr
Tustin, CA 92782-1059

Phone

(714) 321-8854

NPI assigned

Apr 25, 2011

Organization subpart

No

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

Authorized official

Name

Lido Chen, M.D.

Title

Ceo

Phone

(714) 321-8854

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1303689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303689600000",
    "number": "1477844470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12850 CRAWFORD DR",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927821059",
            "telephone_number": "714-321-8854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12850 CRAWFORD DR",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927821059",
            "telephone_number": "714-321-8854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOCAL MEDICAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-25",
        "last_updated": "2011-04-25",
        "status": "A",
        "authorized_official_last_name": "CHEN",
        "authorized_official_first_name": "LIDO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-321-8854",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": "CA",
            "license": "FAC69883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Tustin, CA
• Providers in Tustin, CA by specialty
• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2011; 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.