# PACIFIC SURGICAL CORP.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Pacific Surgical LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922465087
- **Authorized official:** MR. BRIAN EUGENE WHATLEY (CEO/PRINCIPLE OWNER)
- **Authorized official phone:** (916) 548-1880

## Contact information

- **Practice address:** 1110 W. KETTLEMAN LN., SUITE 21, LODI, CA 95240-6047
- **Practice address phone:** (209) 329-6443
- **Practice address fax:** (209) 365-6383
- **Mailing address:** 1110 W. KETTLEMAN LN., SUITE 21, LODI, CA 95240-6047
- **Mailing address phone:** (209) 329-6443
- **Mailing address fax:** (209) 365-6383

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | KH102259891 | CA | Yes |

## Other

- **Enumeration date:** 01/20/2016
- **Last updated:** 01/20/2016