Provider Demographics
NPI:1457471013
Name:SPECIAL CARE PEDIATRICS INC
Entity Type:Organization
Organization Name:SPECIAL CARE PEDIATRICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HAMID
Authorized Official - Middle Name:
Authorized Official - Last Name:MORADI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-881-8210
Mailing Address - Street 1:19231 VICTORY BLVD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-6308
Mailing Address - Country:US
Mailing Address - Phone:818-881-8210
Mailing Address - Fax:818-881-1710
Practice Address - Street 1:19231 VICTORY BLVD
Practice Address - Street 2:SUITE 210
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-6308
Practice Address - Country:US
Practice Address - Phone:818-881-8210
Practice Address - Fax:818-881-1710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service