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General NPI Number Information
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NPI Number | 1134014368
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Entity Type | Organization
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Legal Business Name | PACIFICA PRIMARY CARE MEDICAL GROUP, INC.
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Dates
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Enumeration Date | 06/09/2025
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 16400 PACIFIC COAST HWY STE 220
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92649-1823
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Country | US
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Telephone | 562-832-7662
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Fax | 714-948-5720
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Provider Business Mailing Address
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Address Line | 16400 PACIFIC COAST HWY STE 220
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92649-1823
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JULIE BOLTON
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Credential | DO
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Telephone | 562-832-7662
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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