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General NPI Number Information
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NPI Number | 1811042351
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Entity Type | Organization
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Legal Business Name | SOUTHERN CALIFORNIA IMMEDIATE MEDICAL CENTER
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 03/12/2009
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Provider Practice Location Address
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Address Line | 5203 LAKEWOOD BLVD
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City | LAKEWOOD
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State | CA
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Zip | 90712-2415
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Country | US
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Telephone | 562-633-2273
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Fax | 562-633-1796
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Provider Business Mailing Address
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Address Line | 7300 ALONDRA BLVD STE 101
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City | PARAMOUNT
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State | CA
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Zip | 90723-4000
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Country | US
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Telephone | 562-531-8300
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Fax | 562-531-8035
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | THOMAS ROCCAPALUMBO
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Credential | D.O.
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Telephone | 323-726-3212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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