Healthcare Provider Details

I. General information

NPI: 1316850506
Provider Name (Legal Business Name): PACIFIC EVALUATION MANAGEMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

960 21ST ST APT F
SANTA MONICA CA
90403-3418
US

IV. Provider business mailing address

3101 OCEAN PARK BLVD STE 200 #687
SANTA MONICA CA
90405-3054
US

V. Phone/Fax

Practice location:
  • Phone: 310-499-4339
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: KRISH KUMAR
Title or Position: CEO
Credential:
Phone: 918-900-4858