| Sos | |
|
1014 N Broadway Santa Ana CA 92701-3408 | |
| (949) 270-2132 | |
| Not Available |
| Full Name | Sos |
|---|---|
| Speciality | Clinic/center |
| Location | 1014 N Broadway, Santa Ana, California |
| Authorized Official Name and Position | Kathleen Bruski (CREDENTIALING MANAGER) |
| Authorized Official Contact | 9492702132 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sos 1550 Superior Ave Costa Mesa CA 92627-3653 Ph: (949) 270-2132 | Sos 1014 N Broadway Santa Ana CA 92701-3408 Ph: (949) 270-2132 |
| NPI Number | 1871953745 |
|---|---|
| Provider Enumeration Date | 03/04/2016 |
| Last Update Date | 03/04/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871953745 | NPI | - | NPPES |
| 1508073685 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (NU) | Primary |
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