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NPI Code Detail

MEDICARE: SOUTHERN CALIFORNIA EMERGENCY MEDICINE

MEDICARE: SOUTHERN CALIFORNIA EMERGENCY MEDICINE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1710829262
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTHERN CALIFORNIA EMERGENCY MEDICINE
Provider Business Mailing Address
First Line : 1407 FOOTHILL BLVD # 14
Second Line :
City : LA VERNE
State : CA
Zip : 91750-3451
Country : US
Telephone Number : 909-596-6349
Fax Number :
Provider Business Practice Location Address
First Line : 3480 LA SIERRA AVE STE A
Second Line :
City : RIVERSIDE
State : CA
Zip : 92503-5204
Country : US
Telephone Number : 951-588-8901
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : BRIAN BEARIE
Credential :
Telephone Number : 909-797-8900
Provider Enumeration Date : 04/06/2026
Last Update Date : 04/06/2026

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Directions to “SOUTHERN CALIFORNIA EMERGENCY MEDICINE ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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