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General NPI Number Information
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NPI Number | 1407745649
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Entity Type | Organization
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Legal Business Name | PACIFIC MEDICAL, INC.
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Dates
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Enumeration Date | 07/01/2025
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 2261 LAVA RIDGE CT
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City | ROSEVILLE
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State | CA
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Zip | 95661-3034
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Country | US
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Telephone | 916-788-0530
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Fax | 916-788-0553
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Provider Business Mailing Address
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Address Line | 1700 N CHRISMAN RD
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City | TRACY
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State | CA
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Zip | 95304-9314
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Country | US
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Telephone | 800-726-9180
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Fax |
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Authorized Official
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Title or Position | GENERAL COUNSEL/C.L.O.
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Name | MARK WEAVER
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Credential |
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Telephone | 800-723-9180
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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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 | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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