Healthcare Provider Details

I. General information

NPI: 1629309141
Provider Name (Legal Business Name): PCT MEDICAL SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2010
Last Update Date: 05/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 PASEO LUNA
SAN CLEMENTE CA
92673
US

IV. Provider business mailing address

29 PASEO LUNA
SAN CLEMENTE CA
92673-6501
US

V. Phone/Fax

Practice location:
  • Phone: 949-233-4876
  • Fax: 949-388-7819
Mailing address:
  • Phone: 949-233-4876
  • Fax: 949-388-7819

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171R00000X
TaxonomyInterpreter
License Number
License Number State

VIII. Authorized Official

Name: PAUL HAGOPIAN
Title or Position: PRESIDENT/CEO
Credential:
Phone: 949-233-4876