Pacific Clinics

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PACIFIC CLINICS

Practice address

1126 N Grand Ave
Suites B, C, D
Covina, CA 91724-1551

Phone

(626) 967-1667

Fax

(626) 967-6027

NPI assigned

Feb 27, 2007

Organization subpart

No

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

Authorized official

Name

James J. Balla

Title

President & Chief Executive Officer

Phone

(626) 254-5000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pacific Clinics Children's Intensive Community Services Other name

Locations

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632355200000",
    "number": "1215064159",
    "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": "1126 N GRAND AVE",
            "address_2": "SUITES B, C, D",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917241551",
            "telephone_number": "626-967-1667",
            "fax_number": "626-967-6027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC CLINICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A",
        "authorized_official_last_name": "BALLA",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT & CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "626-254-5000"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7439A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific Clinics Children's Intensive Community Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Michael Oluwaseun Owoaje, MS, CPT
• Erika R Ozuna, BA
• Maria D Pacheco Valencia
• Eric Francis Pachon
• Pacific Clinics
• Pacific Clinics
• Pacific Clinics
• Sofia Padilla de Los Santos
• Elena Natalie Padilla-Velasco
• Alma Padilla

• Community/Behavioral Health Agency in Covina, CA
• Providers in Covina, CA by specialty
• Community/Behavioral Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; 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.