Healthcare Provider Details

I. General information

NPI: 1740251594
Provider Name (Legal Business Name): PACIFICA ORTHOPEDICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18800 DELAWARE ST SUITE 150
HUNTINGTON BEACH CA
92648-1959
US

IV. Provider business mailing address

18800 DELAWARE ST SUITE 150
HUNTINGTON BEACH CA
92648-1959
US

V. Phone/Fax

Practice location:
  • Phone: 714-841-5333
  • Fax: 714-841-5303
Mailing address:
  • Phone: 714-841-5333
  • Fax: 714-841-5303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number19041
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code204C00000X
TaxonomySports Medicine (Neuromusculoskeletal Medicine) Physician
License Number20A4964
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code204C00000X
TaxonomySports Medicine (Neuromusculoskeletal Medicine) Physician
License Number20A4685
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code204C00000X
TaxonomySports Medicine (Neuromusculoskeletal Medicine) Physician
License Number20A4153
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code204C00000X
TaxonomySports Medicine (Neuromusculoskeletal Medicine) Physician
License NumberA70813
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code204C00000X
TaxonomySports Medicine (Neuromusculoskeletal Medicine) Physician
License Number17911
License Number StateCA
# 7
Primary TaxonomyN
Taxonomy Code204C00000X
TaxonomySports Medicine (Neuromusculoskeletal Medicine) Physician
License NumberA29528
License Number StateCA
# 8
Primary TaxonomyY
Taxonomy Code204C00000X
TaxonomySports Medicine (Neuromusculoskeletal Medicine) Physician
License Number20A8191
License Number StateCA

VIII. Authorized Official

Name: DR. PAUL WAKIM
Title or Position: MEDICAL DIRECTOR
Credential: D.O.,F.A.A. ,OO.S.
Phone: 714-841-5333