Organization
PACIFIC MEDICAL, INC.
Active
Other names
Pacific Medical Prosthetics & Orthotics
Organization subpart
No
Provider details
NPI number
Authorized official
MARK LOUIS WEAVER J.D. (GENERAL COUNSEL/C.O.O.)
(800) 726-9180
Entity
Organization
Contact information
Practice address
1700 N. CHRISMAN ROAD, TRACY, CA 95304-9314
(800) 726-9180
(800) 861-5950
Mailing address
FILE 1616, 1801 W OLYMPIC BLVD, PASADENA, CA 91199-1616
(800) 726-9180
(800) 861-5950
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DME01767G
—
CA
Enumeration date
07/27/2005
Last updated
08/09/2013
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