Healthcare Provider Details

I. General information

NPI: 1275609307
Provider Name (Legal Business Name): PACIFIC PALMS ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W HUNTINGTON DR
ARCADIA CA
91007-3402
US

IV. Provider business mailing address

225 S LAKE AVE #535
PASADENA CA
91101-3005
US

V. Phone/Fax

Practice location:
  • Phone: 626-574-3795
  • Fax: 626-821-6955
Mailing address:
  • Phone: 626-795-6596
  • Fax: 626-396-0851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number20A7333
License Number StateCA

VIII. Authorized Official

Name: DR. DARRELL ANTONIO WEBB
Title or Position: PRESIDENT
Credential: D.O.
Phone: 818-240-6111