NPIMap

Organization Active NPI

Southern California Health & Rehabilitation Program

  • Community/Behavioral Health Agency
  • Lynwood, CA
National Provider Identifier
1689793739
Registry record updated May 9, 2018
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
2594 Industry Way
Lynwood, CA 90262-4015
Phone
(310) 667-4070
Fax
(310) 667-4072
NPI assigned
Mar 28, 2007
Last updated
May 9, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2018

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

Authorized official

Name
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 with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

2594 Industry Way
Lynwood, CA 90262-4015

Mailing address

2610 Industry Way
Suite a
Lynwood, CA 90262-4028
Phone (310) 631-8004

Other identifiers 1

IdentifierTypeStateIssuer
7654OtherCAPROVIDER NUMBER

Other names 1

  • SCHARP Child Outpatient Services Other name

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
This NPI is an additional NPI on the 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

Practitioners & affiliated clinicians

Practitioners 63

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 63

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525824000000",
    "number": "1689793739",
    "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": "902624028",
            "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": "2594 INDUSTRY WAY",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902624015",
            "telephone_number": "310-667-4070",
            "fax_number": "310-667-4072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CALIFORNIA HEALTH & REHABILITATION PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2018-05-09",
        "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_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER",
            "identifier": "7654",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SCHARP Child Outpatient Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 May 9, 2018; 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.