Pacific Coast Detox LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

PACIFIC COAST DETOX LLC

Practice address

184 Avenida la Cuesta
San Clemente, CA 92672-3142

Phone

(949) 359-5669

NPI assigned

Dec 5, 2025

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Matthew Lee

Title

Admin

Phone

(619) 987-8078

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1764892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768176000000",
    "number": "1063375129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21263 DOUBTFUL CANYON DR",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774338470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "184 AVENIDA LA CUESTA",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926723142",
            "telephone_number": "949-359-5669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC COAST DETOX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-05",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "ADMIN",
        "authorized_official_telephone_number": "619-987-8078"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carla Midori Osorio
• Jennifer Oswald, PHARMD
• Simon G Outhwaite, MD
• David Raymond Pace, DAVID PACE, PT
• Pacific Clinics
• Pacific Hills Treatment Centers, Inc.
• Pacific Medical California LLC
• Pacific Medical LLC
• Pacific Palms Recovery, LLC.
• Pacific Sleep Lab Inc

• Substance Abuse Rehabilitation Facility in San Clemente, CA
• Providers in San Clemente, CA by specialty
• Substance Abuse Rehabilitation Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.