Organization Active NPI

SCCC a Medical Corporation

  • Cardiovascular Disease Physician
  • Glendale, CA
National Provider Identifier
1760679856
Registry record updated Aug 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
SCCC A MEDICAL CORPORATION
Practice address
1510 S Central Ave
Suite 420
Glendale, CA 91204-2500
Phone
(818) 242-8816
Fax
(818) 242-0610
NPI assigned
Oct 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2010

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

Authorized official

Name
Ms. Aylin I. Hemelians, BS, MHA
Title
Health Administrator
Phone
(818) 242-8816

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

1510 S Central Ave
Suite 420
Glendale, CA 91204-2500

Mailing address

1510 S Central Ave
Suite 420
Glendale, CA 91204-2500
Phone (818) 242-8816

Other identifiers 4

IdentifierTypeStateIssuer
GR0057810MedicaidCA
1407972821OtherCANPI GOODWIN
1366585309OtherCANPI WEN
1851434898OtherCANPI O'CONNOR

Other names 1

  • Southern California Cardiovascular Consultants Other name

National Provider Directory

National Provider Directory

Locations

1510 S Central Ave
Ste 420
Glendale, CA 91204
Phone (818) 242-8816

NPI Registry JSON

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

{
    "created_epoch": "1191283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280707200000",
    "number": "1760679856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 S CENTRAL AVE",
            "address_2": "SUITE 420",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042500",
            "telephone_number": "818-242-8816",
            "fax_number": "818-242-0610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 S CENTRAL AVE",
            "address_2": "SUITE 420",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042500",
            "telephone_number": "818-242-8816",
            "fax_number": "818-242-0610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCCC A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-02",
        "last_updated": "2010-08-02",
        "status": "A",
        "authorized_official_last_name": "HEMELIANS",
        "authorized_official_first_name": "AYLIN",
        "authorized_official_middle_name": "I.",
        "authorized_official_title_or_position": "HEALTH ADMINISTRATOR",
        "authorized_official_telephone_number": "818-242-8816",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "BS, MHA"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0057810",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI GOODWIN",
            "identifier": "1407972821",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI WEN",
            "identifier": "1366585309",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI O'CONNOR",
            "identifier": "1851434898",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern California Cardiovascular Consultants",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2010; 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.