PACIFIC HEALTH MEDICAL GROUP


Address: 319 S Brand Blvd, Glendale, CA 91204-1701
Phone: 8182400006

PACIFIC HEALTH MEDICAL GROUP (NPI# 1902209992) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1902209992
Entity Type Organization
Organization Name PACIFIC HEALTH MEDICAL GROUP
Practice Address 319 S Brand Blvd
Glendale
CA 91204-1701
Practice Telephone 8182400006
Practice Fax Number 8182400038
Mailing Telephone 8182400006
Mailing Fax Number 8182400038
Enumeration Date 2014-10-03
Last Update Date 2014-10-03
Authorized Official Name DR. GAYANE BEGOYAN (MEDICAL DOCTOR)
Authorized Official Telephone 8182400006
Authorized Official Credential M.D.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 261QM0850X Clinic/Center
Specialization: Adult Mental Health
A113904 CA Ambulatory Health Care Facilities
Y 261QM0855X Clinic/Center
Specialization: Adolescent and Children Mental Health
A113904 CA Ambulatory Health Care Facilities

Office Location

Street Address 319 S BRAND BLVD
City GLENDALE
State CA
Zip Code 91204-1701

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Taxonomy Information

Taxonomy Code 261QM0855X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Adolescent and Children Mental Health

Taxonomy Definition

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.
Notes: [7/1/2003: new]

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1992820583 New Horizons Family Center, Inc. Clinic/Center 1251 S Glendale Ave, Glendale, CA 91205-3204 2007-03-20

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Competitor

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City GLENDALE
Zip Code 91204

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Dataset Information

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.

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