Provider Demographics
NPI:1831330513
Name:SOUTHERN CALIFORNIA PULMONARY & CRITICAL CARE ASSOCIATES INC.
Entity type:Organization
Organization Name:SOUTHERN CALIFORNIA PULMONARY & CRITICAL CARE ASSOCIATES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SAEID
Authorized Official - Middle Name:
Authorized Official - Last Name:SAFAEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-637-2200
Mailing Address - Street 1:1511 W GLENOAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91201-1912
Mailing Address - Country:US
Mailing Address - Phone:818-637-2200
Mailing Address - Fax:818-637-2250
Practice Address - Street 1:1511 W GLENOAKS BLVD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91201-1912
Practice Address - Country:US
Practice Address - Phone:818-637-2200
Practice Address - Fax:818-637-2250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-10
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC53279282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAH39957Medicare UPIN