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Contact Information

SOUTHERN CALIFORNIA SPECIALTY CARE, LLC
845 N LARK ELLEN AVE
WEST COVINA, CA91791
 Phone: 626-339-5451
 Fax: 626-967-3809
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

208D00000X 99 Physician/Undefined Physician type[6]
Indicates primary specialty

NPI Profile & details for SOUTHERN CALIFORNIA SPECIALTY CARE LLC · (Female)

NPI # 1164654315
Status Active
Credentials
Entity Individual
Enumeration date 08/20/2009
Last updated 07/23/2018 - About 8 years ago
Sole proprietor 1 Not specified
Identifiers
  • CA Medicaid HSP32028F
  • CA Other ZZZB1900Z BLUE CROSS
  • CA Other 954494848 TRICARE/CHAMPUS
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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