# PCH HEALTHCARE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205507415
- **Authorized official:** INDIGO ALLENDORF (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (657) 422-7586

## Contact information

- **Practice address:** 326 OLD NEWPORT BLVD, NEWPORT BEACH, CA 92663-4121
- **Practice address phone:** (949) 335-8802
- **Mailing address:** 326 OLD NEWPORT BLVD, NEWPORT BEACH, CA 92663-4121

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | — | NULL | Yes |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/27/2021
- **Last updated:** 09/27/2021