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General NPI Number Information
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NPI Number | 1447277231
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Entity Type | Organization
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Legal Business Name | SOUTHERN CALIFORNIA TRANSPLANTATION ASSOCIATES INC
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Dates
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Enumeration Date | 07/16/2006
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Last Update Date | 12/05/2018
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Provider Practice Location Address
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Address Line | 4500 BROCKTON AVE. SUITE 306
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City | RIVERSIDE
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State | CA
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Zip | 92501-4027
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Country | US
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Telephone | 951-275-9000
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Fax | 951-275-5262
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Provider Business Mailing Address
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Address Line | 4500 BROCKTON AVE. SUITE 306
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City | RIVERSIDE
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State | CA
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Zip | 92501-4027
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Country | US
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Telephone | 951-275-9000
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Fax | 951-275-5262
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. MARIA BENAVIDES
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Credential |
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Telephone | 951-275-9000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | A37140
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License Number State | CA
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