Organization
WEST COUNTY MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PRAMESH PRAKASH SHARMA (SR V P)
(661) 254-6630
Entity
Organization
Contact information
Practice address
100 E MARKET STREET, LONG BEACH, CA 90805-5924
(562) 428-4222
(562) 428-0372
Mailing address
26460 SUMMIT CIR, SANTA CLARITA, CA 91350-2991
(661) 254-6630
(661) 254-6644
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
19-037
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19-037
STATE NTP LICENSE
CA
01
—
1946
ADPA
CA
Enumeration date
05/23/2007
Last updated
02/06/2020
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