Provider Demographics
NPI:1225578966
Name:SOUTHERN CALIFORNIA MEDICAL CENTERS, LLC
Entity Type:Organization
Organization Name:SOUTHERN CALIFORNIA MEDICAL CENTERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LINDSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-344-4179
Mailing Address - Street 1:34249 CAMINO CAPISTRANO
Mailing Address - Street 2:SUITE 104
Mailing Address - City:CAPISTRANO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92624
Mailing Address - Country:US
Mailing Address - Phone:800-344-4179
Mailing Address - Fax:949-484-7021
Practice Address - Street 1:34249 CAMINO CAPISTRANO
Practice Address - Street 2:SUITE 104
Practice Address - City:CAPISTRANO BEACH
Practice Address - State:CA
Practice Address - Zip Code:92624
Practice Address - Country:US
Practice Address - Phone:800-344-4179
Practice Address - Fax:949-484-7021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical NeurophysiologyGroup - Multi-Specialty
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction PsychiatryGroup - Multi-Specialty