Organization
PACIFIC OCEAN MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MANOUCHEHR RASHTI M.D. (PRESIDENT)
(310) 268-7707
Entity
Organization
Contact information
Practice address
12340 SANTA MONICA BLVD STE 302, LOS ANGELES, CA 90025-0348
(310) 268-7707
(310) 268-7708
Mailing address
PO BOX 49998, LOS ANGELES, CA 90049-0998
(310) 268-7707
(310) 268-7708
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A401670
—
CA
Enumeration date
07/21/2006
Last updated
09/23/2020
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