NPIMap

Organization Active NPI

Pacific Clinics

  • Community/Behavioral Health Agency
  • Covina, CA
National Provider Identifier
1780873935
Registry record updated Aug 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PACIFIC CLINICS
Practice address
1340 N Enid Ave
Covina, CA 91722-1214
Phone
(626) 815-3619
NPI assigned
Oct 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2016

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

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

Addresses

Primary practice location

1340 N Enid Ave
Covina, CA 91722-1214

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
6843MedicaidCA

Other names 1

  • Pacific Clinics Gladstone High School 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

1340 N Enid Ave
Covina, CA 91722
Phone (626) 815-3600

NPI Registry JSON

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

{
    "created_epoch": "1193097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472515200000",
    "number": "1780873935",
    "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": "1340 N ENID AVE",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917221214",
            "telephone_number": "626-815-3619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC CLINICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-23",
        "last_updated": "2016-08-30",
        "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": "6843",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific Clinics Gladstone High School",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2016; 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.