Healthcare Provider Details

I. General information

NPI: 1720299183
Provider Name (Legal Business Name): PACIFIC COAST HEALTHSYSTEMS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17215 STUDEBAKER RD SUITE 300
CERRITOS CA
90703-2548
US

IV. Provider business mailing address

17215 STUDEBAKER RD SUITE 300
CERRITOS CA
90703-2548
US

V. Phone/Fax

Practice location:
  • Phone: 562-924-7307
  • Fax: 562-860-9398
Mailing address:
  • Phone: 562-924-7307
  • Fax: 562-860-9398

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY 4331
License Number StateCA

VIII. Authorized Official

Name: DR. DENNIS DICK STEELE
Title or Position: OWNER
Credential: PHD.
Phone: 562-924-7307