WESTERN PACIFIC RE-HAB (NPI# 1578902466) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578902466 |
| Entity Type | Organization |
| Organization Name | WESTERN PACIFIC RE-HAB |
| Practice Address |
275 Victoria St Ste 1h Costa Mesa CA 92627 |
| Mailing Address |
4544 San Fernando Rd Suite 202 Glendale CA 91204-1987 |
| Practice Telephone | 9496292862 |
| Mailing Telephone | 8189563737 |
| Mailing Fax Number | 8185436767 |
| Enumeration Date | 2013-06-24 |
| Last Update Date | 2020-01-23 |
| Authorized Official Name | MARK HICKMAN (CEO) |
| 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 |
30-12 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | CALIFORNIA DRUG MEDI-CAL | 3098 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205275195 | Western Pacific Re-hab | Clinic/Center | 11902 Rosecrans Ave Ste A&d, Norwalk, CA 90650-4197 | 2013-06-24 |
| 1881033777 | Western Pacific Re-hab | Clinic/Center | 9462 Van Nuys Blvd, Panorama City, CA 91402-1310 | 2013-06-24 |
| 1770922650 | Western Pacific Re-hab | Clinic/Center | 4544 San Fernando Rd, Suite 201, Glendale, CA 91204-1987 | 2013-06-24 |
| 1871932764 | Western Pacific Re-hab | Clinic/Center | 45335 Sierra Hwy, Lancaster, CA 93534-1611 | 2013-06-24 |
| 1437598323 | Western Pacific Re-hab | Clinic/Center | 7232 Canby Ave, Suites 4,5,6, Reseda, CA 91335-3006 | 2013-06-24 |
| 1922447812 | Western Pacific Re-hab | Clinic/Center | 218 E Commonwealth Ave, Fullerton, CA 92832-1911 | 2013-06-24 |
| Street Address |
275 VICTORIA ST STE 1H |
| City | COSTA MESA |
| State | CA |
| Zip Code | 92627 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326358052 | Margaret M Shannon, Md, Inc | Dermatology | 275 Victoria St Ste 1h, Costa Mesa, CA 92627-1906 | 2010-10-15 |
| 1588262380 | Rosario Zatarain | Counselor | 275 Victoria St Ste 1h, Costa Mesa, CA 92627-1906 | 2020-10-14 |
| 1851883300 | Cynthia Castillo | Counselor | 275 Victoria St Ste 1h, Costa Mesa, CA 92627-1906 | 2018-05-31 |
| 1245722784 | Bridget O'connell | Registered Nurse | 275 Victoria St Ste 1h, Costa Mesa, CA 92627-1906 | 2018-05-31 |
| 1649762188 | Patana Pongvarin | Registered Nurse | 275 Victoria St Ste 1h, Costa Mesa, CA 92627-1906 | 2018-05-31 |
| 1619469152 | Yasmine Furlong | Registered Nurse | 275 Victoria St Ste 1h, Costa Mesa, CA 92627-1906 | 2018-05-31 |
| 1144712696 | Darcel Jackson | Counselor | 275 Victoria St Ste 1h, Costa Mesa, CA 92627-1906 | 2018-05-31 |
| 1710479266 | Khadine Baptiste | Counselor | 275 Victoria St Ste 1h, Costa Mesa, CA 92627-1906 | 2018-05-31 |
| 1609387604 | Kimberly Sue Burciaga | Counselor | 275 Victoria St Ste 1h, Costa Mesa, CA 92627-1906 | 2017-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902407174 | Ryan Allen Merrell | Technician | 313 E. 17th Pl #l Costa Mesa, Costa Mesa, CA 92627 | 2020-11-04 |
| 1245703412 | Allure Transportation | Non-emergency Medical Transport (VAN) | 1835 Newport Blvd Ste 109 #110, Costa Mesa, CA 92627 | 2019-01-09 |
| 1750857686 | Living Success Center | Marriage & Family Therapist | 445 E. 17th Street, Suites D & E, Costa Mesa, CA 92627 | 2018-10-18 |
| 1790298909 | Akua Behavioral Health, Inc | Substance Abuse Rehabilitation Facility | 319-a University Drive, Costa Mesa, CA 92627 | 2017-11-09 |
| 1679086862 | Akua Behavioral Health, Inc | Substance Abuse Rehabilitation Facility | 319-b University Drive, Costa Mesa, CA 92627 | 2017-11-09 |
| 1245759018 | Surgical Assistant Associates | Clinic/Center | 186 E. 16th Street, Suite C, Costa Mesa, CA 92627 | 2017-09-13 |
| 1366962334 | Guadalupe A. Mejia Dental Corp. | Dentist | 700 W 19th St., Suite C, Costa Mesa, CA 92627 | 2017-06-21 |
| 1386189033 | Jian Yi Ye | Acupuncturist | 2488 Newport Blvd Ste B1, Costa Mesa, CA 92627 | 2017-01-04 |
| 1144764606 | Michele Marie Patton | Dental Hygienist | 2220 Fairview Rd., Costa Mesa, CA 92627 | 2016-12-18 |
| 1881148500 | Valerie Nguyen | Pharmacist | 1835 Newport Blvd # C, Costa Mesa, CA 92627 | 2016-08-10 |
| Find all providers in zip 92627 | ||||
| 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 | ||||
| City | COSTA MESA |
| Zip Code | 92627 |
Please comment or provide details below to improve the information on WESTERN PACIFIC RE-HAB.
| 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.