Organization
PACIFIC MEDICAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK L. WEAVER (GENERAL COUNSEL/C.O.O.)
(800) 726-9180
Entity
Organization
Contact information
Practice address
1335 COFFEE RD, SUITE 210, MODESTO, CA 95355-3188
(209) 524-3113
(209) 524-3254
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
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Enumeration date
08/29/2008
Last updated
03/10/2014
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