NPIMap

Organization Active NPI

Pacific Clinics

  • Community/Behavioral Health Agency
  • Yucca Valley, CA
National Provider Identifier
1205007606
Registry record updated Jun 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PACIFIC CLINICS
Practice address
58945 Business Center Dr
Suite D
Yucca Valley, CA 92284-7307
Phone
(760) 228-9657
Fax
(760) 369-6258
NPI assigned
Mar 13, 2008
Last updated
Jun 24, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2014

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

Authorized official

Name
Dr. Susan Mandel, PH.D.NPI 1063551232
Title
President/Ceo
Phone
(626) 254-5000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

58945 Business Center Dr
Suite D
Yucca Valley, CA 92284-7307

Mailing address

800 S Santa Anita Ave
Arcadia, CA 91006-6853
Phone (626) 254-5000

Other identifiers 1

IdentifierTypeStateIssuer
36D1MedicaidCA

Other names 1

  • Pacific Clinics TAY-Yucca Other name

National Provider Directory

National Provider Directory
Tax ID family
Pacific Clinics40 organizations share this tax ID, including this one

Other organizations with this tax ID 39

Organizations that report the same tax identification number in the National Provider Directory.

View all 39

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1205366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403568000000",
    "number": "1205007606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 S SANTA ANITA AVE",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910066853",
            "telephone_number": "626-254-5000",
            "fax_number": "626-294-1077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58945 BUSINESS CENTER DR",
            "address_2": "SUITE D",
            "city": "YUCCA VALLEY",
            "state": "CA",
            "postal_code": "922847307",
            "telephone_number": "760-228-9657",
            "fax_number": "760-369-6258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC CLINICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-13",
        "last_updated": "2014-06-24",
        "status": "A",
        "authorized_official_last_name": "MANDEL",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "626-254-5000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36D1",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific Clinics TAY-Yucca",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Yucca Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2014; 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.