MEDICARE: PACIFIC CLINICS

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1700062676
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PACIFIC CLINICS

Provider Business Mailing Address
First Line	:	800 S SANTA ANITA AVE
Second Line	:
City	:	ARCADIA
State	:	CA
Zip	:	91006-6853
Country	:	US
Telephone Number	:	626-254-5000
Fax Number	:	626-294-1077

Provider Business Practice Location Address
First Line	:	141 W 5TH ST
Second Line	:	SUITE D
City	:	OXNARD
State	:	CA
Zip	:	93030-7105
Country	:	US
Telephone Number	:	805-240-2538
Fax Number	:	805-486-0957

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	DR. SUSAN MANDEL
Credential	:
Telephone Number	:	626-254-5000

Provider Enumeration Date	:	01/10/2008
Last Update Date	:	01/10/2008

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Directions to “PACIFIC CLINICS ” Practice Location

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