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Organization
GREAT PACIFIC MEDICAL GROUP INC
Active
Organization
GREAT PACIFIC MEDICAL GROUP INC
Active
Parent organization
GREAT PACIFIC MEDICAL GROUP INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
GREAT PACIFIC MEDICAL GROUP INC
Authorized official
DR. THAN A. LUU MD (MEDICAL DIRECTOR)
(805) 434-0900
Entity
Organization
Contact information
Practice address
265 POSADA LN, SUITE B, TEMPLETON, CA 93465-4056
(805) 434-0900
Mailing address
2980 N BEVERLY GLEN CIR, SUITE 301, LOS ANGELES, CA 90077-1726
(310) 474-9809
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
NULL
Other
Enumeration date
06/15/2012
Last updated
11/27/2012
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