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General NPI Number Information
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NPI Number | 1093814113
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Entity Type | Organization
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Legal Business Name | PC MEDICAL CLINIC INC
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 27141 HIDAWAY AVE STE 204
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City | SANTA CLARITA
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State | CA
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Zip | 91351-4147
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Country | US
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Telephone | 661-397-1177
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Fax | 661-397-6175
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Provider Business Mailing Address
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Address Line | 27141 HIDAWAY AVE STE 204
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City | SANTA CLARITA
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State | CA
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Zip | 91351-4147
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Country | US
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Telephone | 661-397-1177
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Fax | 661-367-6175
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARINA GOLD
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Credential | MD
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Telephone | 661-293-1177
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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