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General NPI Number Information
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NPI Number | 1609029974
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Entity Type | Organization
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Legal Business Name | PACIFIC HEALTH SOLUTIONS, INC.
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Dates
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Enumeration Date | 10/30/2008
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Last Update Date | 11/13/2008
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Provider Practice Location Address
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Address Line | 541 10TH ST NW # 124
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City | ATLANTA
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State | GA
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Zip | 30318-5713
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Country | US
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Telephone | 404-454-6136
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Fax | 404-393-0685
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Provider Business Mailing Address
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Address Line | 541 10TH ST NW # 124
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City | ATLANTA
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State | GA
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Zip | 30318-5713
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Country | US
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Telephone | 404-454-6136
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Fax | 404-393-0685
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Authorized Official
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Title or Position | CEO
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Name | ALBERTO ESTEVEZ
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Credential |
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Telephone | 404-454-6136
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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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