NPIMap

Organization Active NPI

Socal Psychiatric Medical Group, a Medical Corporation

  • Psychologist
  • Los Angeles, CA
National Provider Identifier
1770686347
Registry record updated Jun 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
SOCAL PSYCHIATRIC MEDICAL GROUP, A MEDICAL CORPORATION
Practice address
3250 Wilshire Blvd
Suite 930
Los Angeles, CA 90010-1438
Phone
(213) 739-0019
Fax
(213) 739-0091
NPI assigned
Sep 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2008

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

Authorized official

Name
Stuart L Zubrick, PHD
Title
Managing Partner
Phone
(213) 739-0019

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X Primary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X

Addresses

Primary practice location

3250 Wilshire Blvd
Suite 930
Los Angeles, CA 90010-1438

Mailing address

3250 Wilshire Blvd
Suite 930
Los Angeles, CA 90010-1438
Phone (213) 739-0019

Other names 1

  • Industrial Psychiatric Network Doing business as

National Provider Directory

National Provider Directory

Locations

3250 Wilshire Blvd
Ste 930
Los Angeles, CA 90010
Phone (213) 739-0019

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213920000000",
    "number": "1770686347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3250 WILSHIRE BLVD",
            "address_2": "SUITE 930",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900101438",
            "telephone_number": "213-739-0019",
            "fax_number": "213-739-0091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3250 WILSHIRE BLVD",
            "address_2": "SUITE 930",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900101438",
            "telephone_number": "213-739-0019",
            "fax_number": "213-739-0091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOCAL PSYCHIATRIC MEDICAL GROUP, A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-07",
        "last_updated": "2008-06-20",
        "status": "A",
        "authorized_official_last_name": "ZUBRICK",
        "authorized_official_first_name": "STUART",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "213-739-0019",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Industrial Psychiatric Network",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2008; 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.