Pacorpnation

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA21762 Issued in CA

Legal business name

PACORPNATION

Practice address

12665 Garden Grove Blvd Ste 713
Garden Grove, CA 92843-1921

Phone

(714) 537-7500

Fax

(714) 537-2176

NPI assigned

Jun 10, 2014

Organization subpart

No

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

Authorized official

Name

Moises Alvarez-Fernandez

Title

Ceo

Phone

(559) 920-2873

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1402358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402358400000",
    "number": "1629481312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 S HARBOR BLVD APT 223",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927042371",
            "telephone_number": "559-920-2873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12665 GARDEN GROVE BLVD STE 713",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431921",
            "telephone_number": "714-537-7500",
            "fax_number": "714-537-2176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACORPNATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-10",
        "last_updated": "2014-06-10",
        "status": "A",
        "authorized_official_last_name": "ALVAREZ-FERNANDEZ",
        "authorized_official_first_name": "MOISES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "559-920-2873"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA21762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pacific Diagnostics
• Pacific DX Idtf
• Pacific Optometry Group, Inc
• Pacita M Braza, Inc.
• Scarlett Angelica Packer
• Gillian Neille Salazar Paderogo
• Gloria Padilla Casillas, CHW
• Catherine Louise Padilla
• David Padilla
• David Chavez Padilla

• Medical Physician Assistant in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.