Organization
SOUTHERN CALIFORNIA MEDICAL CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELLIE ZARE (SR. PROGRAM MANAGER)
(818) 650-6700
Entity
Organization
Contact information
Practice address
502 W HOLT AVE, POMONA, CA 91768-3604
(909) 620-8500
(909) 620-5799
Mailing address
PO BOX 436, VAN NUYS, CA 91408-0436
(818) 421-0809
(909) 620-5799
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261Q00000X
Clinic/Center
—
—
261QC1500X
Community Health Clinic/Center
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
261QF0050X
Non-Surgical Family Planning Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QR0206X
Mammography Clinic/Center
—
—
Other
Enumeration date
03/26/2020
Last updated
06/13/2023
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