Pacific Coast Clinic Salem LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

MD24295 Issued in OR

Legal business name

PACIFIC COAST CLINIC SALEM LLC

Practice address

1249 Fairview Ave SE
Salem, OR 97302-2534

Phone

(971) 239-1146

Fax

(503) 907-9933

NPI assigned

Feb 11, 2010

Last updated

Jun 1, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Erum Ayaz Khaleeq, MD

Title

Psychiatrist

Phone

(971) 239-1146

Specialties & licenses 1

Addresses

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.

• Erum S Khaleeq

  • Psychiatry Physician
  • Keizer, OR
  • NPI 1902915770
  NPD

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

{
    "created_epoch": "1265846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306886400000",
    "number": "1669704805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1249 FAIRVIEW AVE SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973022534",
            "telephone_number": "971-239-1146",
            "fax_number": "503-907-9933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1249 FAIRVIEW AVE SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973022534",
            "telephone_number": "971-239-1146",
            "fax_number": "503-907-9933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC COAST CLINIC SALEM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-11",
        "last_updated": "2011-06-01",
        "status": "A",
        "authorized_official_last_name": "KHALEEQ",
        "authorized_official_first_name": "ERUM",
        "authorized_official_middle_name": "AYAZ",
        "authorized_official_title_or_position": "PSYCHIATRIST",
        "authorized_official_telephone_number": "971-239-1146",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "OR",
            "license": "MD24295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Alyssa Pacheco
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• Pacific Eye Group, PC.
• Pacific Family Medical Center LLC
• Pacific Family Medical Center LLC
• Pacific Family Medical Center LLC
• Pacific Medical, Inc. (Pacific Medical Prosthetics & Orthotics)

• Adult Mental Health Clinic/Center in Salem, OR
• Providers in Salem, OR by specialty
• Adult Mental Health Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 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.