institution
Southern California Specialty Care, Llc
General Practice Physician in West Covina, California
NPI 1164654315

Southern California Specialty Care, Llc is a General Practice Physician based in West Covina, CA. Southern California Specialty Care, Llc practices in West Covina, CA. The NPI Number for Southern California Specialty Care, Llc is 1164654315 and holds a License No. (California).

The current practice location address for Southern California Specialty Care, Llc is 845 N Lark Ellen Ave, West Covina, CA and can be reached out via phone at 626-339-5451 and via fax at 626-967-3809. You can also correspond with Southern California Specialty Care, Llc through the mailing address at 845 N LARK ELLEN AVE, WEST COVINA, CA - 91791-1069 (mailing address contact number: 626-339-5451).

Location: 845 N Lark Ellen Ave, West Covina, CA, 91791-1069
institution
Provider Profile Details
NPI Number
1164654315
Provider Name
Southern California Specialty Care, Llc
Credential
Provider Entity Type
Organization
Address
845 N Lark Ellen Ave, West Covina, CA, 91791-1069
Phone Number
626-339-5451
Fax Number
626-967-3809
Provider Enumeration Date
08/20/2009
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
HSP32028F 05 CA
954494848 01 CA TRICARE/CHAMPUS
ZZZB1900Z 01 CA BLUE CROSS
institution
Provider Business Practice Location Address Details
Address
845 N Lark Ellen Ave
City
State
Zip
91791
Phone Number
626-339-5451
Fax Number
626-967-3809
person
Provider Business Mailing Address Details
Address
845 N Lark Ellen Ave
City
State
Zip
91791
Phone Number
626-339-5451
Fax Number
626-967-3809
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
License No.
()
Definition
Definition to come...
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