Organization
WESTERN PACIFIC MED-CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFERY STEVEN BLAKE (DIRECTOR OF OPERATIONS)
(818) 956-3737
Entity
Organization
Contact information
Practice address
26921 CROWN VALLEY PKWY STE 200, MISSION VIEJO, CA 92691-6501
(818) 956-3737
(818) 543-6767
Mailing address
4544 SAN FERNANDO RD STE 202, GLENDALE, CA 91204-5015
(818) 956-3737
(818) 543-6767
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
—
—
Other
Enumeration date
11/19/2019
Last updated
11/19/2019
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