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Organization
PACIFIC CLINICS
Active
Organization
PACIFIC CLINICS
Active
Other names
Pacific Clinics Rancho TAY Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN MANDEL PH.D. (PRESIDENT/CEO)
(626) 254-5000
Entity
Organization
Contact information
Practice address
9047 ARROW RTE, SUITE 170, RANCHO CUCAMONGA, CA 91730-4449
(909) 466-8696
(909) 948-0457
Mailing address
800 S SANTA ANITA AVE, ARCADIA, CA 91006-6853
(626) 254-5000
(626) 294-1077
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36D2
—
CA
Enumeration date
03/13/2008
Last updated
07/22/2011
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