Southern California Fatty Liver Center Inc

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

SOUTHERN CALIFORNIA FATTY LIVER CENTER INC

Practice address

2436 Fenton St # 100
Chula Vista, CA 91914-3516

Phone

(619) 377-8391

NPI assigned

Jun 9, 2025

Organization subpart

No

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

Authorized official

Name

Mr. Tarek Hassanein

Title

Operations

Phone

(619) 990-1698

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1749427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760572800000",
    "number": "1528953882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 ORANGE AVE STE 100",
            "city": "CORONADO",
            "state": "CA",
            "postal_code": "921181408",
            "telephone_number": "619-377-8391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2436 FENTON ST # 100",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919143516",
            "telephone_number": "619-377-8391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CALIFORNIA FATTY LIVER CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-09",
        "last_updated": "2025-10-16",
        "certification_date": "2025-10-16",
        "status": "A",
        "authorized_official_last_name": "HASSANEIN",
        "authorized_official_first_name": "TAREK",
        "authorized_official_title_or_position": "OPERATIONS",
        "authorized_official_telephone_number": "619-990-1698",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Bethany Souza
• Daryl J Spak, MD

• Multi-Specialty Clinic/Center in Chula Vista, CA
• Providers in Chula Vista, 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 Oct 16, 2025; 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.