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Organization
PACIFIC CLINICS
Active
Organization
PACIFIC CLINICS
Active
Other names
PACIFIC CLINICS TBS PROGRAM
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES J. BALLA (PRESIDENT & CHIEF EXECUTIVE OFFICER)
(626) 254-5000
Entity
Organization
Contact information
Practice address
58945 BUSINESS CENTER DR, SUITE D, YUCCA VALLEY, CA 92284-7307
(760) 228-9657
(760) 369-6758
Mailing address
800 S SANTA ANITA AVE, ARCADIA, CA 91006-3536
(626) 254-5000
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36EC
—
CA
Enumeration date
07/22/2011
Last updated
12/09/2016
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