Organization
PACIFICA PAIN MANAGEMENT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY K. MILLS PH.D. (DIRECTOR)
(707) 963-1493
Entity
Organization
Contact information
Practice address
1700 SOSCOL AVE, SUITE 25, NAPA, CA 94559-1351
(707) 963-1493
(707) 963-1463
Mailing address
1700 SOSCOL AVE, SUITE 25, NAPA, CA 94559-1351
(707) 963-1493
(707) 963-1463
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
280015AP
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
280015 AP
FACILITY LICENSE
CA
01
—
PSY4876
LICENSE
CA
Enumeration date
07/29/2006
Last updated
09/14/2012
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