Organization
PACIFIC CLINICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN MANDEL PH.D. (PRESIDENT CEO)
(626) 254-5000
Entity
Organization
Contact information
Practice address
622 WALL ST, E215, LOS ANGELES, CA 90014-2314
(213) 689-0295
Mailing address
1020 S ARROYO PKWY, PASADENA, CA 91105-3911
(626) 403-4888
(626) 403-4894
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
225400000X
CA
Other
Enumeration date
03/16/2007
Last updated
07/22/2008
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