WESTERN PACIFIC MED-CORP (NPI# 1942342811) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942342811 |
| Entity Type | Organization |
| Organization Name | WESTERN PACIFIC MED-CORP |
| Practice Address |
10751 Dale Ave Stanton CA 90680-2604 |
| 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 |
30-10 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | DRUG MEDICAL PROVIDER | 3098 | 01 |
| CA | MEDICAL PROVIDER | CMM70074F | 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 |
| 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 |
10751 DALE AVE |
| City | STANTON |
| State | CA |
| Zip Code | 90680-2604 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275132144 | Nedra Mitchell | Counselor | 10751 Dale Ave, Stanton, CA 90680-2604 | 2020-10-21 |
| 1063997419 | Tiffani Buonanno | Counselor | 10751 Dale Ave, Stanton, CA 90680-2604 | 2018-10-02 |
| 1295210219 | Christine Ciscone | Counselor | 10751 Dale Ave, Stanton, CA 90680-2604 | 2018-09-25 |
| 1629560412 | Patricia Eason | Licensed Vocational Nurse | 10751 Dale Ave, Stanton, CA 90680-2604 | 2018-06-06 |
| 1063904860 | Rossi Ceniceros | Counselor | 10751 Dale Ave, Stanton, CA 90680-2604 | 2018-06-06 |
| 1497100069 | Jeffery Boots | Counselor | 10751 Dale Ave, Stanton, CA 90680-2604 | 2016-05-02 |
| 1467816454 | Brandy Lyn Martin | Counselor | 10751 Dale Ave, Stanton, CA 90680-2604 | 2016-04-06 |
| 1659739332 | Debra Padua | Counselor | 10751 Dale Ave, Stanton, CA 90680-2604 | 2016-02-09 |
| 1417340225 | Niccole Marie Molina | Counselor | 10751 Dale Ave, Stanton, CA 90680-2604 | 2015-03-18 |
| 1417349333 | Jeff Schrick | Counselor | 10751 Dale Ave, Stanton, CA 90680-2604 | 2015-03-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962978429 | Mountain View Hospice | Hospice Care, Community Based | 12235 Beach Blvd., Suite 205c, Stanton, CA 90680 | 2018-10-22 |
| 1073983250 | Jennifer Van | Dental Hygienist | 10882 Cedar Street, Stanton, CA 90680 | 2015-10-01 |
| 1780097915 | Chris G Kim | Acupuncturist | 7731 Katella Ave #b, Stanton, CA 90680 | 2014-06-05 |
| 1982035069 | San Blas Medical Clinic | General Practice | 7777 Katella Avenue, Stanton, CA 90680 | 2013-11-27 |
| 1487969861 | Dean Tran, D.o., Inc | Clinic/Center | 11418 1/2 Renaissance Way, Stanton, CA 90680 | 2010-08-10 |
| 1255562229 | Ability Center | Durable Medical Equipment & Medical Supplies | 11600 Western Ave, Stanton, CA 90680 | 2009-08-07 |
| 1235369786 | Diem-trinh Maria Nguyen | Dentist | 532 E Chapman, Orange, CA 90680 | 2009-07-17 |
| 1932315959 | Esther L Sy | Dentist | 10468 Beach Boulevard, Stanton, CA 90680 | 2007-05-15 |
| 1255409694 | Minh Duc Nguyen | Dentist | 12880 Beach Blvd, Stuite Aa, Stanton, CA 90680 | 2006-12-02 |
| 1780750612 | Go Diagnostics Inc | Specialist/Technologist, Other | 7159 Katella Ave, Stanton, CA 90680 | 2006-11-24 |
| Find all providers in zip 90680 | ||||
| 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 | ||||
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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.