Pacific Restorative Center

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

PACIFIC RESTORATIVE CENTER

Practice address

1456 Professional Drive
Suite 404
Petaluma, CA 94954

Phone

(707) 800-7633

Fax

(707) 843-3485

NPI assigned

Aug 17, 2015

Organization subpart

No

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

Authorized official

Name

Jason Pope, MD

Title

Medical Director

Phone

(707) 623-9803

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1439769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494547200000",
    "number": "1083080717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1456 PROFESSIONAL DRIVE",
            "address_2": "SUITE 404",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "94954",
            "telephone_number": "707-800-7633",
            "fax_number": "707-843-3485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1456 PROFESSIONAL DRIVE",
            "address_2": "SUITE 404",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "94954",
            "telephone_number": "707-800-7633",
            "fax_number": "707-843-3485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC RESTORATIVE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-17",
        "last_updated": "2017-05-12",
        "status": "A",
        "authorized_official_last_name": "POPE",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "707-623-9803",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bradley Kimball Osgood, D.C.
• Farid Osman, MD
• Robert I Ostroff, M.D.
• Sierra M Overton
• Pacific Advanced Surgical Services
• Pacific Standard Physical Therapy, Incorporated
• Berenice Padilla-Perez
• Laura A Pajari
• Jesebel Amelia Palacios Lopez
• Lynne Dee Palma, ARNP

• Ambulatory Surgical Clinic/Center in Petaluma, CA
• Providers in Petaluma, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2017; 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.