| Southern California Medical Center, Inc. | |
|
14550 Haynes St Van Nuys CA 91411-1613 | |
| (818) 650-6700 | |
| (818) 933-5038 |
| Full Name | Southern California Medical Center, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 14550 Haynes St, Van Nuys, California |
| Authorized Official Name and Position | Sheila Busheri (CEO) |
| Authorized Official Contact | 8186506700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern California Medical Center, Inc. 14550 Haynes St Fl 3 Van Nuys CA 91411-4116 Ph: (818) 650-6700 | Southern California Medical Center, Inc. 14550 Haynes St Van Nuys CA 91411-1613 Ph: (818) 650-6700 |
| NPI Number | 1255729661 |
|---|---|
| Provider Enumeration Date | 01/07/2015 |
| Last Update Date | 11/02/2022 |
| Medicare PECOS PAC ID | 2769666817 |
|---|---|
| Medicare Enrollment ID | O20161117002521 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255729661 | NPI | - | NPPES |
| Provider Name | Souna Mohseni |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205415254 PECOS PAC ID: 0244693687 Enrollment ID: I20230831003508 |
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