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General NPI Number Information
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NPI Number | 1831601053
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Entity Type | Organization
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Legal Business Name | PACIFIC HEIGHTS HEALTHCARE, INC
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Dates
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Enumeration Date | 10/27/2017
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Last Update Date | 10/31/2017
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Provider Practice Location Address
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Address Line | 26060 ACERO
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City | MISSION VIEJO
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State | CA
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Zip | 92691-2768
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Country | US
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Telephone | 949-580-1061
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1598
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City | IRVINE
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State | CA
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Zip | 92619-1598
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Country | US
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Telephone | 949-580-1061
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JULIE THOMAS
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Credential | MD
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Telephone | 949-580-1061
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number | G061513
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | G061513
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License Number State | CA
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