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NPI Code Detail

MEDICARE: PACIFIC CLINICS

MEDICARE: PACIFIC CLINICS
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
1171M00000XCase Manager/Care Coordinator
2251C00000XDevelopmentally Disabled Services Day Training Agency
3251X00000XSupports Brokerage Agency
4251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1710132691
Entity Type Code : Organization
Provider Name (Legal Business Name) : PACIFIC CLINICS
Provider Business Mailing Address
First Line : 251 LLEWELLYN AVE
Second Line :
City : CAMPBELL
State : CA
Zip : 95008-1940
Country : US
Telephone Number : 408-379-3790
Fax Number : 408-364-4013
Provider Business Practice Location Address
First Line : 3680 E IMPERIAL HWY
Second Line : SUITE 220 & 240
City : LYNWOOD
State : CA
Zip : 90262-2663
Country : US
Telephone Number : 323-769-7174
Fax Number :
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER / PRESIDENT
Name : KATHRYN MCCARTHY
Credential :
Telephone Number : 408-379-3790
Provider Enumeration Date : 11/19/2008
Last Update Date : 05/22/2024

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Directions to “PACIFIC CLINICS ” Practice Location

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