Healthcare Provider Details

I. General information

NPI: 1942342969
Provider Name (Legal Business Name): PACIFIC CLINICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 03/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27822 EL LAZO
LAGUNA NIGUEL CA
92677-3915
US

IV. Provider business mailing address

800 S SANTA ANITA AVE
ARCADIA CA
91006-6853
US

V. Phone/Fax

Practice location:
  • Phone: 949-360-5810
  • Fax:
Mailing address:
  • Phone: 626-254-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: SUSAN SHEARER
Title or Position: SENIOR VICE PRESIDENT
Credential: L.C.S.W.
Phone: 626-254-5000