# GREAT PACIFIC MEDICAL GROUP INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** GREAT PACIFIC MEDICAL GROUP INC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1316200256
- **Legal business name:** GREAT PACIFIC MEDICAL GROUP INC
- **Authorized official:** DR. THAN A. LUU MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (805) 434-0900

## Contact information

- **Practice address:** 265 POSADA LN, SUITE B, TEMPLETON, CA 93465-4056
- **Practice address phone:** (805) 434-0900
- **Mailing address:** 2980 N BEVERLY GLEN CIR, SUITE 301, LOS ANGELES, CA 90077-1726
- **Mailing address phone:** (310) 474-9809

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332900000X | Non-Pharmacy Dispensing Site | — | NULL | Yes |

## Other

- **Enumeration date:** 06/15/2012
- **Last updated:** 11/27/2012