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CHC28368-02 SOUTHERN CALIFORNIA MEDICAL CENTER, INC. (Active)
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Main Details
Name
SOUTHERN CALIFORNIA MEDICAL CENTER, INC.
Subdivision Name
SCMC Van Nuys
Type
HRSA-Funded Health Center
Site ID
BPS-H80-019224
340B ID
CHC28368-02
Grant Number
H80CS28368
Additional Details
Current Program Status
Active
Registration Date
4/11/2017
Participating Start Date
7/1/2017
Participating Approval Date
4/21/2017
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
Southern California Medical Center
Abbas Hosseini, System Manager
(818) 421-1035
Primary Contact
Southern California Medical Center
Eli Agha, Data Analyst Assistant
(818) 939-1810
Addresses
Street Address
14550 Haynes Street
Van Nuys, CA 91411-1613
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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May 2025
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