WESTERN PACIFIC MED-CORP (NPI# 1780726653) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780726653 |
| Entity Type | Organization |
| Organization Name | WESTERN PACIFIC MED-CORP |
| Practice Address |
11902 Rosecrans Ave Norwalk CA 90650-4197 |
| Mailing Address |
4544 San Fernando Rd Suite 202 Glendale CA 91204-1987 |
| Practice Telephone | 8189563737 |
| Enumeration Date | 2007-02-13 |
| 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 |
19-114 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | DRUG MEDICAL PROVIDER | 1968 | 01 |
| CA | MEDICAL PROVIDER | HDC70023F | 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 |
| 1235272196 | Western Pacific Med-corp | Clinic/Center | 14332 Victory Blvd, Van Nuys, CA 91401-1944 | 2007-02-14 |
| 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 |
| 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 |
11902 ROSECRANS AVE |
| City | NORWALK |
| State | CA |
| Zip Code | 90650-4197 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528679669 | William Vance Ortiz | Counselor | 11902 Rosecrans Ave, Norwalk, CA 90650-4197 | 2020-08-12 |
| 1194375154 | Diane Valadez | Licensed Vocational Nurse | 11902 Rosecrans Ave, Norwalk, CA 90650-4197 | 2019-09-12 |
| 1194373274 | Howard Brigoli Trazo | Licensed Psychiatric Technician | 11902 Rosecrans Ave, Norwalk, CA 90650-4197 | 2019-08-31 |
| 1073161352 | Armando Estevane | Licensed Vocational Nurse | 11902 Rosecrans Ave, Norwalk, CA 90650-4197 | 2019-08-29 |
| 1518513654 | Alma Aburto | Counselor | 11902 Rosecrans Ave, Norwalk, CA 90650-4197 | 2019-08-14 |
| 1639548332 | Cynthia Calvario | Counselor | 11902 Rosecrans Ave, Norwalk, CA 90650-4197 | 2015-09-23 |
| 1770959157 | Valerie Gaylord | Counselor | 11902 Rosecrans Ave, Norwalk, CA 90650-4197 | 2015-08-19 |
| 1679958144 | Bernadino Hernandez | Counselor | 11902 Rosecrans Ave, Norwalk, CA 90650-4197 | 2015-07-27 |
| 1831571488 | Michael Torres | Counselor | 11902 Rosecrans Ave, Norwalk, CA 90650-4197 | 2015-06-19 |
| 1659774883 | Western Pacific Med Corp | Health Maintenance Organization | 11902 Rosecrans Ave, Norwalk, CA 90650-4197 | 2014-10-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003420316 | Ricky Chavez | Occupational Therapist | 13603 Halcourt Avenue, Norwalk, CA 90650 | 2020-09-03 |
| 1326671652 | Ryan Ly | Psychologist | 11400 Bloomfield Blvd, Norwalk, CA 90650 | 2020-02-14 |
| 1710416177 | Ricky O Lee | Pharmacist | 11401 S. Bloomfield Ave, Norwalk, CA 90650 | 2017-06-08 |
| 1689108847 | Eliana Segura | Student in an Organized Health Care Education/Training Program | 12440 Firestone Ave Blvd., 3020, Norwalk, CA 90650 | 2017-04-14 |
| 1396282752 | Martin Sanchez Torres | Specialist/Technologist, Other | 14003 Summer Ave, Norwalk, CA 90650 | 2017-01-24 |
| 1952859837 | Fatimah Busran | Social Worker | 11401 South Bloomfield Avde., Norwalk, CA 90650 | 2016-09-20 |
| 1760939383 | Andy Chang | Licensed Psychiatric Technician | 12440 East Imperial Highway, Suite 116, Norwalk, CA 90650 | 2016-09-01 |
| 1548634322 | Leslie Yesenia Lazo | Student in an Organized Health Care Education/Training Program | 12440 E. Firestone Blvd, Norwalk, CA 90650 | 2015-11-17 |
| 1306247994 | Ruth Vergara | Student in an Organized Health Care Education/Training Program | 21520 S. Pioneer Blvd., Suite 110, Hawaiian Gardens, CA 90650 | 2014-09-15 |
| 1265854251 | Sungmin Yee | Acupuncturist | 12706 Bloomfield Ave, Apt. 135, Norwalk, CA 90650 | 2014-01-10 |
| Find all providers in zip 90650 | ||||
| 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 |
|---|---|---|---|---|
| 1205275195 | Western Pacific Re-hab | Clinic/Center | 11902 Rosecrans Ave Ste A&d, Norwalk, CA 90650-4197 | 2013-06-24 |
| 1073639266 | Connecticut Counseling Centers, Inc | Clinic/Center | 20 N Main St, Norwalk, CT 06854-2656 | 2007-03-21 |
| 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 | ||||
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| 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.