Pacific Coast Medical Clinic

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

20A9504 Issued in CA

Legal business name

PACIFIC COAST MEDICAL CLINIC

Practice address

3067 Moorpark Ave
Suite 100
San Jose, CA 95128

Phone

(408) 438-2248

Fax

(408) 244-7248

NPI assigned

Mar 17, 2015

Organization subpart

No

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

Authorized official

Name

Ms. Afsoun Sue Panahi

Title

President

Phone

(408) 438-2248

Specialties & licenses 3

Addresses

Other names 1

• PCMC Other name

Locations

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

{
    "created_epoch": "1426550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430438400000",
    "number": "1821481722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3067 MOORPARK AVE",
            "address_2": "SUITE 100",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95128",
            "telephone_number": "408-438-2248",
            "fax_number": "408-244-7248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3067 MOORPARK AVE",
            "address_2": "SUITE 100",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95128",
            "telephone_number": "408-438-2248",
            "fax_number": "408-244-7248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC COAST MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-17",
        "last_updated": "2015-05-01",
        "status": "A",
        "authorized_official_last_name": "PANAHI",
        "authorized_official_first_name": "AFSOUN",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "408-438-2248",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "32345",
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Naturopath",
            "state": "CA",
            "license": "ND-588",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "CA",
            "license": "20A9504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PCMC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Pacific Clinics
• Pacific Clinics
• Pacific Clinics
• Pacific Clinics
• Pacific Clinics
• Pacific Coast Sports & Physical Therapy Inc.
• Pacific Endocrine Diabetes Health Center, Inc.
• Pacific Medical, Inc.
• Pacific Partners Medical Group Inc.
• Pacific Pharmacy

• All providers in San Jose, CA
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2015; 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.