Organization
LA COAST PACE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLARA JAQUES (EXECUTIVE DIRECTOR)
(562) 206-1681
Entity
Organization
Contact information
Practice address
1220 E 4TH ST, LONG BEACH, CA 90802-1831
(650) 741-0743
Mailing address
405 EL CAMINO REAL # 248, MENLO PARK, CA 94025-5240
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
—
—
Other
Enumeration date
07/26/2018
Last updated
03/25/2025
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