WESTERN PACIFIC MED-CORP (NPI# 1750423620) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1750423620 |
Entity Type | Organization |
Organization Name | WESTERN PACIFIC MED-CORP |
Practice Address |
218 E Commonwealth Ave Fullerton CA 92832-1911 |
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 |
30-11 | CA | Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CA | MEDICAL PROVIDER | CMM70208F | 01 |
CA | DRUG MEDICAL PROVIDER | 3099 | 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 |
1376685230 | Western Pacific Med-corp | Clinic/Center | 9462 Van Nuys Blvd, Panorama City, CA 91402-1310 | 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 |
1124160080 | Western Pacific Med-corp | Clinic/Center | 4838 Laurel Canyon Blvd, North Hollywood, CA 91607-3717 | 2007-02-13 |
Street Address |
218 E COMMONWEALTH AVE |
City | FULLERTON |
State | CA |
Zip Code | 92832-1911 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1184270720 | Emilio Lopez | Counselor | 218 E Commonwealth Ave, Fullerton, CA 92832-1911 | 2019-08-09 |
1548823362 | Kristin Huntress | Counselor | 218 E Commonwealth Ave, Fullerton, CA 92832-1911 | 2019-04-17 |
1154883155 | Vicky Castorena | Counselor | 218 E Commonwealth Ave, Fullerton, CA 92832-1911 | 2019-04-01 |
1679039333 | Kristine Callahan | Counselor | 218 E Commonwealth Ave, Fullerton, CA 92832-1911 | 2019-02-18 |
1245731827 | Crystal Avelino | Counselor | 218 E Commonwealth Ave, Fullerton, CA 92832-1911 | 2018-02-28 |
1972003614 | Kelly Campos | Counselor | 218 E Commonwealth Ave, Fullerton, CA 92832-1911 | 2018-02-20 |
1629577739 | Omar Rizvi | Counselor | 218 E Commonwealth Ave, Fullerton, CA 92832-1911 | 2018-02-04 |
1750899456 | Donna Bracken | Counselor | 218 E Commonwealth Ave, Fullerton, CA 92832-1911 | 2018-01-16 |
1386156347 | Carmen Stanfield | Counselor | 218 E Commonwealth Ave, Fullerton, CA 92832-1911 | 2017-10-31 |
1326577107 | Travis Griffin | Counselor | 218 E Commonwealth Ave, Fullerton, CA 92832-1911 | 2017-06-06 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932735669 | Diana Hernandez | Behavior Technician | 413 W Commonwealth Ave, Suite C, Fullerton, CA 92832 | 2020-03-13 |
1942830013 | Karen Marie Winkle | Speech-Language Pathologist | 812 Lois Lane, Fullerton, CA 92832 | 2020-01-17 |
1578122487 | Andrea Arevalo | Behavior Technician | 713 Commonwealth Ave, Suite C, Fullerton, CA 92832 | 2019-06-13 |
1275090193 | Madison Elizabeth Miller | Behavior Technician | 714 W Commonwealth Ave, Suite C, Fullerton, CA 92832 | 2019-02-27 |
1528525862 | Samantha Rivas | Behavior Technician | 713 W Commonwealth Ave., Suite C, Fullerton, CA 92832 | 2019-02-22 |
1760948483 | Marcus Gerard Chavez | Behavioral Analyst | 713 West Commonwealth Suite A, Fullerton, U.S.A 92832 | 2019-02-19 |
1710443437 | Rolando Jimenez | Behavior Technician | 713 W. Commonwealth, Suite A, La Habra, CA 92832 | 2019-02-18 |
1659872919 | Anthony James Arneson | Marriage & Family Therapist | 120 N Lawrence, Fullerton, CA 92832 | 2018-02-22 |
1407302243 | Be Well Pharmacy Inc | Pharmacy | 105 N Lawrence Ave, Fullerton, CA 92832 | 2016-08-31 |
1871907972 | Edward Walls | Counselor | 771 W.orangethorpe Ave., Fullerton, CA 92832 | 2014-06-17 |
Find all providers in zip 92832 |
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 |
---|---|---|---|---|
1922447812 | Western Pacific Re-hab | Clinic/Center | 218 E Commonwealth Ave, Fullerton, CA 92832-1911 | 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 |
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.