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NPI Code Detail

MEDICARE: SOUTHERN CALIFORNIA ADDICTION CENTER

MEDICARE: SOUTHERN CALIFORNIA ADDICTION CENTER
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
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1508393265
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTHERN CALIFORNIA ADDICTION CENTER
Provider Business Mailing Address
First Line : 2755 BRISTOL ST STE 140
Second Line :
City : COSTA MESA
State : CA
Zip : 92626-5985
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 44065 MARGARITA RD
Second Line :
City : TEMECULA
State : CA
Zip : 92592-2741
Country : US
Telephone Number : 714-619-5081
Fax Number :
Authorized Official
Title or Position : CEO
Name : AARON BROWER
Credential :
Telephone Number : 714-619-5081
Provider Enumeration Date : 05/12/2017
Last Update Date : 03/17/2018

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Directions to “SOUTHERN CALIFORNIA ADDICTION CENTER ” Practice Location

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