Pacific Surgical Corp.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

KH102259891 Issued in CA

Legal business name

PACIFIC SURGICAL CORP.

Practice address

1110 W. Kettleman LN.
Suite 21
Lodi, CA 95240-6047

Phone

(209) 329-6443

Fax

(209) 365-6383

NPI assigned

Jan 20, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Brian Eugene Whatley

Title

Ceo/Principle Owner

Phone

(916) 548-1880

Specialties & licenses 1

Addresses

Other names 1

• Pacific Surgical LLC Former legal business name

Locations

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

{
    "created_epoch": "1453248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453248000000",
    "number": "1922465087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 W. KETTLEMAN LN.",
            "address_2": "SUITE 21",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952406047",
            "telephone_number": "209-329-6443",
            "fax_number": "209-365-6383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 W. KETTLEMAN LN.",
            "address_2": "SUITE 21",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952406047",
            "telephone_number": "209-329-6443",
            "fax_number": "209-365-6383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC SURGICAL CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-20",
        "last_updated": "2016-01-20",
        "status": "A",
        "authorized_official_last_name": "WHATLEY",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "CEO/PRINCIPLE OWNER",
        "authorized_official_telephone_number": "916-548-1880",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "KH102259891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific Surgical LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Outreach Ministries International
• Sara Kathleen Ownbey, ACSW
• P. Gill Obsteterics & Gynecology Medical Group, Inc
• P. Gill Obstetrics & Gynecology Medical Group, Inc.
• Pacific Heart and Vascular Medical Group
• Brenda Jisel Palafox Rodriguez
• Brittany Nicole Palish, DPT
• Sharon Elizabeth Palmer, M.S. CCC-SLP
• Pornpit Nit Paluch, LVN
• Brenden F Panzarello, MD

• Durable Medical Equipment & Medical Supplies in Lodi, CA
• Providers in Lodi, CA by specialty
• Durable Medical Equipment & Medical Supplies in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 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.