MEDICARE: THE PAJO CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center	19.151	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649307869
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE PAJO CORPORATION

Provider Business Mailing Address
First Line	:	11900 AVALON BLVD
Second Line	:	SUITE 200
City	:	LOS ANGELES
State	:	CA
Zip	:	90061-2837
Country	:	US
Telephone Number	:	323-242-0500
Fax Number	:	323-242-0600

Provider Business Practice Location Address
First Line	:	11900 AVALON BLVD
Second Line	:	SUITE 200
City	:	LOS ANGELES
State	:	CA
Zip	:	90061-2837
Country	:	US
Telephone Number	:	323-242-0500
Fax Number	:	323-242-0600

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MRS. CAROLYN PERRY
Credential	:	PA
Telephone Number	:	323-242-0500

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	05/24/2016

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Directions to “THE PAJO CORPORATION ” Practice Location

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