WESTERN PACIFIC MED-CORP (NPI# 1376685230) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376685230 |
| Entity Type | Organization |
| Organization Name | WESTERN PACIFIC MED-CORP |
| Practice Address |
9462 Van Nuys Blvd Panorama City CA 91402-1310 |
| Mailing Address |
4544 San Fernando Rd Suite 202 Glendale CA 91204-1987 |
| Practice Telephone | 8189563737 |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2015-09-28 |
| Authorized Official Name | MARK HICKMAN (C.E.O.) |
| Authorized Official Telephone | 8189563737 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2800X |
Clinic/Center Specialization: Methadone Clinic |
19-088 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDICAL PROVIDER | CMM70054F | 01 |
| CA | DRUG MEDICAL PROVIDER | 7000 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386280899 | Western Pacific Med-corp | Clinic/Center | 26921 Crown Valley Pkwy Ste 200, Mission Viejo, CA 92691-6501 | 2019-11-19 |
| 1235272196 | Western Pacific Med-corp | Clinic/Center | 14332 Victory Blvd, Van Nuys, CA 91401-1944 | 2007-02-14 |
| 1942342811 | Western Pacific Med-corp | Clinic/Center | 10751 Dale Ave, Stanton, CA 90680-2604 | 2007-02-13 |
| 1669514527 | Western Pacific Med-corp | Clinic/Center | 7232 Canby Ave, Suites 4,5,6, Reseda, CA 91335-3006 | 2007-02-13 |
| 1790827657 | Western Pacific Med-corp | Clinic/Center | 45335 Sierra Hwy, Lancaster, CA 93534-1611 | 2007-02-13 |
| 1780726653 | Western Pacific Med-corp | Clinic/Center | 11902 Rosecrans Ave, Norwalk, CA 90650-4197 | 2007-02-13 |
| 1003958976 | Western Pacific Med-corp | Clinic/Center | 955 E Thompson Blvd, Ventura, CA 93001-3008 | 2007-02-13 |
| 1235271180 | Western Pacific Med-corp | Clinic/Center | 4544 San Fernando Rd, Suite 201, Glendale, CA 91204-1987 | 2007-02-13 |
| 1750423620 | Western Pacific Med-corp | Clinic/Center | 218 E Commonwealth Ave, Fullerton, CA 92832-1911 | 2007-02-13 |
| 1124160080 | Western Pacific Med-corp | Clinic/Center | 4838 Laurel Canyon Blvd, North Hollywood, CA 91607-3717 | 2007-02-13 |
| Street Address |
9462 VAN NUYS BLVD |
| City | PANORAMA CITY |
| State | CA |
| Zip Code | 91402-1310 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639782808 | Jackeline Escobar | Licensed Vocational Nurse | 9462 Van Nuys Blvd, Panorama City, CA 91402-1310 | 2020-08-27 |
| 1336768118 | Scott Edward Keeling-torrez | Counselor | 9462 Van Nuys Blvd, Panorama City, CA 91402-1310 | 2020-04-13 |
| 1124653357 | Patricia Quintana | Counselor | 9462 Van Nuys Blvd, Panorama City, CA 91402-1310 | 2020-03-09 |
| 1942848262 | Pamela Aulike Erwin | Registered Nurse | 9462 Van Nuys Blvd, Panorama City, CA 91402-1310 | 2019-12-17 |
| 1093363178 | Magda Sayes | Licensed Vocational Nurse | 9462 Van Nuys Blvd, Panorama City, CA 91402-1310 | 2019-08-31 |
| 1467000612 | Kimberly Joy Dacquel Cabanting | Registered Nurse | 9462 Van Nuys Blvd, Panorama City, CA 91402-1310 | 2019-08-30 |
| 1487123220 | Leah Gurvitz | Counselor | 9462 Van Nuys Blvd, Panorama City, CA 91402-1310 | 2018-11-23 |
| 1225512676 | Geena Marie Miller | Counselor | 9462 Van Nuys Blvd, Panorama City, CA 91402-1310 | 2018-09-21 |
| 1760974406 | Silvia Estrada | Counselor | 9462 Van Nuys Blvd, Panorama City, CA 91402-1310 | 2018-05-30 |
| 1063950095 | Shari Owens | Counselor | 9462 Van Nuys Blvd, Panorama City, CA 91402-1310 | 2017-02-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457900979 | Natalie Levine | Physician Assistant | 9140 Van Nuys Blvd Ste 207, Panorama City, CA 91402 | 2019-09-06 |
| 1609423912 | Jannet De La Torre | Student in an Organized Health Care Education/Training Program | 8018 Broadleaf Ave., Panorama City, CA 91402 | 2019-08-21 |
| 1659838258 | Carlota Andon | Psychologist | 14907 Willard St., Panorama City, CA 91402 | 2019-03-01 |
| 1477037471 | Lisa Diaz | Respiratory Therapist, Registered | 13651 Cantara St, Panorama City, CA 91402 | 2018-09-17 |
| 1124500665 | Luis Valentine Ascencio Jr. | Respiratory Therapist, Certified | Southern Calif. Kaiser Permanente Hospital, 8110 Woodman Ave Building 5, Panorama City, CA 91402 | 2018-08-31 |
| 1669951562 | Floyd Bailey | Respiratory Therapist, Registered | 8110 Woodman Ave Bldg 5, Panorama City, CA 91402 | 2018-08-10 |
| 1265910285 | St. Rita's Congregate, Inc. | Nursing Facility/Intermediate Care Facility | 7818 Allott Ave, Van Nuys, CA 91402 | 2018-08-01 |
| 1255834370 | Bishoy Saad | Student in an Organized Health Care Education/Training Program | 8435 Minuet Pl, Panorama City, CA 91402 | 2018-03-15 |
| 1376080309 | International Pre-diabetes Center Inc | Registered Nurse | 14500 Roscoe Blvd., 4th Floor, 4th Floor, Panorama City, CA 91402 | 2017-01-29 |
| 1023489176 | Jane Ryang | Pharmacist | 13652 Cantara Street, Mo4 Room 105, Panorama City, CA 91402 | 2015-10-15 |
| Find all providers in zip 91402 | ||||
| Taxonomy Code | 261QM2800X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Methadone Clinic |
| An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881033777 | Western Pacific Re-hab | Clinic/Center | 9462 Van Nuys Blvd, Panorama City, CA 91402-1310 | 2013-06-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083224141 | Aegis Treatment Centers, LLC | Clinic/Center | 1450 Bessie Ave Ste B, Tracy, CA 95376-3456 | 2020-08-04 |
| 1093323222 | City and County of San Francisco | Clinic/Center | 1001 Potrero Ave # Ward86, San Francisco, CA 94110-3518 | 2020-07-14 |
| 1548899644 | Bella Team Ltd. | Clinic/Center | 2618 San Miguel Dr Ste 1288, Newport Beach, CA 92660-5437 | 2020-04-02 |
| 1386280899 | Western Pacific Med-corp | Clinic/Center | 26921 Crown Valley Pkwy Ste 200, Mission Viejo, CA 92691-6501 | 2019-11-19 |
| 1518501527 | Harmonic Solutions LLC | Clinic/Center | 1776 Ygnacio Valley Rd Ste 206, Walnut Creek, CA 94598-3125 | 2019-11-01 |
| 1326698887 | Aegis Treatment Centers, LLC | Clinic/Center | 2107, 2109 & 2113 1st St, Eureka, CA 95501-0840 | 2019-09-17 |
| 1548819550 | Aegis Treatment Centers, LLC | Clinic/Center | 1111 W Inyokern Rd Ste B, Ridgecrest, CA 93555-2370 | 2019-09-11 |
| 1306326699 | Kristen Andree Rickard | Clinic/Center | 1153 Paradise Trail Rd, Chula Vista, CA 91915-2502 | 2018-08-16 |
| 1083141600 | Baart Behavioral Health Services, Inc. | Clinic/Center | 1145 Market St Fl 10, San Francisco, CA 94103-1566 | 2017-05-13 |
| 1013448547 | Coachella Valley Treatment Center | Clinic/Center | 81709 Dr Carreon Blvd Ste B1, Indio, CA 92201-5510 | 2017-03-26 |
| Find all providers with the same taxonomy | ||||
| City | PANORAMA CITY |
| Zip Code | 91402 |
Please comment or provide details below to improve the information on WESTERN PACIFIC MED-CORP.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.