WESTERN PACIFIC MED-CORP (NPI# 1235272196) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235272196 |
| Entity Type | Organization |
| Organization Name | WESTERN PACIFIC MED-CORP |
| Practice Address |
14332 Victory Blvd Van Nuys CA 91401-1944 |
| Mailing Address |
4544 San Fernando Rd Suite 202 Glendale CA 91204-1987 |
| Practice Telephone | 8189563737 |
| Mailing Telephone | 8189563737 |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2015-09-28 |
| Authorized Official Name | MARK HICKMAN (C.E.O.) |
| Authorized Official Telephone | 8189563737 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2800X |
Clinic/Center Specialization: Methadone Clinic |
19-138 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDICAL PROVIDER | HDC70061F | 01 |
| CA | DRUG MEDICAL PROVIDER | 6805 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386280899 | Western Pacific Med-corp | Clinic/Center | 26921 Crown Valley Pkwy Ste 200, Mission Viejo, CA 92691-6501 | 2019-11-19 |
| 1942342811 | Western Pacific Med-corp | Clinic/Center | 10751 Dale Ave, Stanton, CA 90680-2604 | 2007-02-13 |
| 1669514527 | Western Pacific Med-corp | Clinic/Center | 7232 Canby Ave, Suites 4,5,6, Reseda, CA 91335-3006 | 2007-02-13 |
| 1790827657 | Western Pacific Med-corp | Clinic/Center | 45335 Sierra Hwy, Lancaster, CA 93534-1611 | 2007-02-13 |
| 1376685230 | Western Pacific Med-corp | Clinic/Center | 9462 Van Nuys Blvd, Panorama City, CA 91402-1310 | 2007-02-13 |
| 1780726653 | Western Pacific Med-corp | Clinic/Center | 11902 Rosecrans Ave, Norwalk, CA 90650-4197 | 2007-02-13 |
| 1003958976 | Western Pacific Med-corp | Clinic/Center | 955 E Thompson Blvd, Ventura, CA 93001-3008 | 2007-02-13 |
| 1235271180 | Western Pacific Med-corp | Clinic/Center | 4544 San Fernando Rd, Suite 201, Glendale, CA 91204-1987 | 2007-02-13 |
| 1750423620 | Western Pacific Med-corp | Clinic/Center | 218 E Commonwealth Ave, Fullerton, CA 92832-1911 | 2007-02-13 |
| 1124160080 | Western Pacific Med-corp | Clinic/Center | 4838 Laurel Canyon Blvd, North Hollywood, CA 91607-3717 | 2007-02-13 |
| Street Address |
14332 VICTORY BLVD |
| City | VAN NUYS |
| State | CA |
| Zip Code | 91401-1944 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326696584 | Jennifer Diano Zelaya | Licensed Vocational Nurse | 14332 Victory Blvd, Van Nuys, CA 91401-1944 | 2019-08-30 |
| 1174905053 | John Miller | Counselor | 14332 Victory Blvd, Van Nuys, CA 91401-1944 | 2015-06-26 |
| 1720390594 | Margarita Martirosyan | Counselor | 14332 Victory Blvd, Van Nuys, CA 91401-1944 | 2010-07-09 |
| 1912195199 | John Calderon | Counselor | 14332 Victory Blvd, Van Nuys, CA 91401-1944 | 2007-10-12 |
| 1376757880 | Arthur Poordawood | Counselor | 14332 Victory Blvd, Van Nuys, CA 91401-1944 | 2007-05-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467004101 | Express Homeservice Inc | Home Health | 13515 Victory Blvd Suite 207, Van Nuys, CA 91401 | 2019-07-12 |
| 1285192690 | Community Care Hospice,inc. | Hospice Care, Community Based | 13629 1/2 Victory Blvd., Van Nuys, CA 91401 | 2019-03-05 |
| 1124501242 | Steven Vu Pham | Pharmacist | 5601 Van Nuys Boulevard, Sherman Oaks, CA 91401 | 2018-09-14 |
| 1184116469 | Well Care Home Health Care Inc | Home Health | 13735 Victory Blvd Ste 3, Van Nuys, CA 91401 | 2018-06-03 |
| 1821504911 | Martha J Rivas-mendoza | Specialist/Technologist | 3130 Burbank Blvd, Sherman Oaks, CA 91401 | 2017-12-27 |
| 1780104687 | Jessica Tang | Marriage & Family Therapist | 13130 Burbank Boulevard, Sherman Oaks, CA 91401 | 2017-06-21 |
| 1184152530 | Creative Approach Residential Inc. | Clinic/Center | 5348 Allott Ave., Sherman Oaks, CA 91401 | 2017-05-30 |
| 1578004503 | David Mashadian Chiropractic Dc Inc | Chiropractor | 14401 Sylvan St #101, Van Nuys, CA 91401 | 2017-03-09 |
| 1154872414 | A.n.t. Hospice Inc | Hospice Care, Community Based | 13629 1/2 Victory Blvd, Van Nuys, CA 91401 | 2016-10-20 |
| 1245785070 | Jack Bayraymyan Dental Group Inc. | Dentist | 14424 Victory Blvd., Van Nuys, CA 91401 | 2016-08-22 |
| Find all providers in zip 91401 | ||||
| Taxonomy Code | 261QM2800X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Methadone Clinic |
| An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083224141 | Aegis Treatment Centers, LLC | Clinic/Center | 1450 Bessie Ave Ste B, Tracy, CA 95376-3456 | 2020-08-04 |
| 1093323222 | City and County of San Francisco | Clinic/Center | 1001 Potrero Ave # Ward86, San Francisco, CA 94110-3518 | 2020-07-14 |
| 1548899644 | Bella Team Ltd. | Clinic/Center | 2618 San Miguel Dr Ste 1288, Newport Beach, CA 92660-5437 | 2020-04-02 |
| 1386280899 | Western Pacific Med-corp | Clinic/Center | 26921 Crown Valley Pkwy Ste 200, Mission Viejo, CA 92691-6501 | 2019-11-19 |
| 1518501527 | Harmonic Solutions LLC | Clinic/Center | 1776 Ygnacio Valley Rd Ste 206, Walnut Creek, CA 94598-3125 | 2019-11-01 |
| 1326698887 | Aegis Treatment Centers, LLC | Clinic/Center | 2107, 2109 & 2113 1st St, Eureka, CA 95501-0840 | 2019-09-17 |
| 1548819550 | Aegis Treatment Centers, LLC | Clinic/Center | 1111 W Inyokern Rd Ste B, Ridgecrest, CA 93555-2370 | 2019-09-11 |
| 1306326699 | Kristen Andree Rickard | Clinic/Center | 1153 Paradise Trail Rd, Chula Vista, CA 91915-2502 | 2018-08-16 |
| 1083141600 | Baart Behavioral Health Services, Inc. | Clinic/Center | 1145 Market St Fl 10, San Francisco, CA 94103-1566 | 2017-05-13 |
| 1013448547 | Coachella Valley Treatment Center | Clinic/Center | 81709 Dr Carreon Blvd Ste B1, Indio, CA 92201-5510 | 2017-03-26 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on WESTERN PACIFIC MED-CORP.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.