Healthcare Provider Details

I. General information

NPI: 1275822751
Provider Name (Legal Business Name): SOUTHERN CALIFORNIA TMS CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2011
Last Update Date: 07/06/2023
Certification Date: 07/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 S LAKE AVE SUITE 615
PASADENA CA
91101
US

IV. Provider business mailing address

180 S LAKE AVE SUITE 615
PASADENA CA
91101-2663
US

V. Phone/Fax

Practice location:
  • Phone: 626-683-9158
  • Fax: 626-683-9207
Mailing address:
  • Phone: 626-683-9158
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License NumberG69246
License Number StateCA

VIII. Authorized Official

Name: TODD MITCHELL HUTTON
Title or Position: OWNER
Credential: M.D.
Phone: 626-683-9158