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Organization
SOUTHERN CALIFORNIA PHYSICIAN NETWORK, INC
Active
Organization
SOUTHERN CALIFORNIA PHYSICIAN NETWORK, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL NDUATI (PRESIDENT)
(951) 200-7385
Entity
Organization
Contact information
Practice address
2250 S MAIN ST STE 201, CORONA, CA 92882-2536
(951) 621-3232
(951) 882-6967
Mailing address
PO BOX 3046, MALVERN, PA 19355-0746
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083002075
—
CA
01
—
CA307699
MEDICARE PIN
CA
Enumeration date
12/30/2014
Last updated
05/17/2024
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