Provider Demographics
NPI:1255039715
Name:SO-CAL COMMUNITY HEALTH CENTER
Entity type:Organization
Organization Name:SO-CAL COMMUNITY HEALTH CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:KAHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-746-2626
Mailing Address - Street 1:9700 WOODMAN AVE STE A10
Mailing Address - Street 2:
Mailing Address - City:ARLETA
Mailing Address - State:CA
Mailing Address - Zip Code:91331-8040
Mailing Address - Country:US
Mailing Address - Phone:818-746-2626
Mailing Address - Fax:818-746-2623
Practice Address - Street 1:9700 WOODMAN AVE STE A10
Practice Address - Street 2:
Practice Address - City:ARLETA
Practice Address - State:CA
Practice Address - Zip Code:91331-8040
Practice Address - Country:US
Practice Address - Phone:818-746-2626
Practice Address - Fax:818-746-2623
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-23
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health