Southern California Industrial Clinic

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

SOUTHERN CALIFORNIA INDUSTRIAL CLINIC

Practice address

21064 Centre Point Pkwy
Santa Clarita, CA 91350

Phone

(877) 392-7767

NPI assigned

Dec 2, 2021

Organization subpart

No

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

Authorized official

Name

Kelly Sellers

Title

Administrator

Phone

(877) 392-7767

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1638403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638403200000",
    "number": "1861150336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3435 E THOUSAND OAKS BLVD UNIT 7779",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913598052",
            "telephone_number": "877-392-7767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21064 CENTRE POINT PKWY",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "91350",
            "telephone_number": "877-392-7767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CALIFORNIA INDUSTRIAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-02",
        "last_updated": "2021-12-02",
        "certification_date": "2021-11-18",
        "status": "A",
        "authorized_official_last_name": "SELLERS",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "877-392-7767"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Santa Clarita, CA
• Providers in Santa Clarita, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2021; 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.