NPIMap

Organization Active NPI

Pacific Clinics

  • Community/Behavioral Health Agency
  • Rancho Cucamonga, CA
National Provider Identifier
1306017702
Registry record updated Jul 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PACIFIC CLINICS
Practice address
9047 Arrow Rte
Suite 170
Rancho Cucamonga, CA 91730-4449
Phone
(909) 466-8696
Fax
(909) 948-0457
NPI assigned
Mar 13, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2011

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

Authorized official

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

Specialties & licenses 1

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

Addresses

Primary practice location

9047 Arrow Rte
Suite 170
Rancho Cucamonga, CA 91730-4449

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
36D2MedicaidCA

Other names 1

  • Pacific Clinics Rancho TAY Center 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

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": "1311292800000",
    "number": "1306017702",
    "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": "9047 ARROW RTE",
            "address_2": "SUITE 170",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917304449",
            "telephone_number": "909-466-8696",
            "fax_number": "909-948-0457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC CLINICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-13",
        "last_updated": "2011-07-22",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36D2",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific Clinics Rancho TAY Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2011; 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.