Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
SOUTHERN CALIFORNIA SPECIALTY CARE, LLC
Active
Organization
SOUTHERN CALIFORNIA SPECIALTY CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MOSTAFA ADAM DARVISH (EXECUTIVE DIRECTOR)
(714) 893-4541
Entity
Organization
Contact information
Practice address
845 N LARK ELLEN AVE, WEST COVINA, CA 91791
(626) 339-5451
(626) 967-3809
Mailing address
845 N LARK ELLEN AVE, WEST COVINA, CA 91791-1069
(626) 339-5451
(626) 967-3809
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
954494848
TRICARE/CHAMPUS
CA
05
—
HSP32028F
—
CA
01
—
ZZZB1900Z
BLUE CROSS
CA
Enumeration date
08/20/2009
Last updated
07/23/2018
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers