Provider Demographics
NPI:1932435047
Name:SOUTHERN CALIFORNIA PHYSICIAN CONSULTANTS SOLUTIONS, PC
Entity type:Organization
Organization Name:SOUTHERN CALIFORNIA PHYSICIAN CONSULTANTS SOLUTIONS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:SAMMY
Authorized Official - Last Name:RASHWAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-885-5522
Mailing Address - Street 1:PO BOX 79723
Mailing Address - Street 2:
Mailing Address - City:CITY OF INDUSTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91716-9723
Mailing Address - Country:US
Mailing Address - Phone:330-470-3700
Mailing Address - Fax:330-497-7940
Practice Address - Street 1:18300 ROSCOE BLVD.
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91328
Practice Address - Country:US
Practice Address - Phone:818-885-5440
Practice Address - Fax:818-885-5497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-23
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACT275AMedicare PIN