# SOUTHERN CALIFORNIA MEDICAL CENTER, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255729661
- **Authorized official:** SHEILA BUSHERI (CEO)
- **Authorized official phone:** (818) 650-6700

## Contact information

- **Practice address:** 14550 HAYNES ST, VAN NUYS, CA 91411-1613
- **Practice address phone:** (818) 650-6700
- **Practice address fax:** (818) 933-5038
- **Mailing address:** 14550 HAYNES ST FL 3, VAN NUYS, CA 91411-4116
- **Mailing address phone:** (818) 650-6700
- **Mailing address fax:** (818) 933-5038

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 261Q00000X | Clinic/Center | — | NULL | — |
| 261QC1500X | Community Health Clinic/Center | — | NULL | Yes |
| 261QD0000X | Dental Clinic/Center | — | NULL | — |
| 261QF0050X | Non-Surgical Family Planning Clinic/Center | — | NULL | — |
| 261QF0400X | Federally Qualified Health Center (FQHC) | — | NULL | — |
| 261QH0100X | Health Service Clinic/Center | — | NULL | — |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | — |
| 261QR0200X | Radiology Clinic/Center | — | NULL | — |
| 261QR0206X | Mammography Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 01/07/2015
- **Last updated:** 11/02/2022