Organization
CENTURY PACIFIC MEDICAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTOR NODTVEDT (OWNER)
(949) 360-7242
Entity
Organization
Contact information
Practice address
115 GAUGUIN CIR, ALISO VIEJO, CA 92656-3878
(800) 239-4119
(866) 528-9127
Mailing address
PO BOX 1419, LAKE FOREST, CA 92609-1419
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
CA
332BC3200X
Customized Equipment (DME)
—
CA
333600000X
Pharmacy
—
CA
3336H0001X
Home Infusion Therapy Pharmacy
—
CA
335E00000X
Prosthetic/Orthotic Supplier
—
CA
3416L0300X
Land Ambulance
—
CA
343800000X
Secured Medical Transport (VAN)
—
CA
343900000X
Non-emergency Medical Transport (VAN)
—
CA
347C00000X
Private Vehicle
—
CA
Other
Enumeration date
08/07/2012
Last updated
04/08/2021
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