NPIMap

Organization Active NPI

Pacific Clinics

  • Community/Behavioral Health Agency
  • Moreno Valley, CA
National Provider Identifier
1386828275
Registry record updated Dec 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PACIFIC CLINICS
Practice address
13800 Heacock St
Suites C236 & C210
Moreno Valley, CA 92553-3339
Phone
(951) 653-0819
Fax
(951) 656-2614
NPI assigned
Dec 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2010

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

Authorized official

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

Specialties & licenses 1

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

Addresses

Primary practice location

13800 Heacock St
Suites C236 & C210
Moreno Valley, CA 92553-3339

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
33HXMedicaidCA

Other names 1

  • Pacific Clinics Riverside TBS Expansion Program 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

Locations

13800 Heacock St
Ste C210
Moreno Valley, CA 92553
Phone (951) 653-0819

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1198713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292198400000",
    "number": "1386828275",
    "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": "13800 HEACOCK ST",
            "address_2": "SUITES C236 & C210",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925533339",
            "telephone_number": "951-653-0819",
            "fax_number": "951-656-2614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC CLINICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-27",
        "last_updated": "2010-12-13",
        "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": "PHD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33HX",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific Clinics Riverside TBS Expansion Program",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Moreno Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2010; 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.