Provider Demographics
NPI:1013034222
Name:PACIFIC CLININCS
Entity Type:Organization
Organization Name:PACIFIC CLININCS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LVN
Authorized Official - Prefix:
Authorized Official - First Name:EMMA
Authorized Official - Middle Name:OLIVIA
Authorized Official - Last Name:PINTADO-BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-403-4888
Mailing Address - Street 1:623 MONTEREY AVE
Mailing Address - Street 2:
Mailing Address - City:MONROVIA
Mailing Address - State:CA
Mailing Address - Zip Code:91016-3228
Mailing Address - Country:US
Mailing Address - Phone:626-256-8988
Mailing Address - Fax:
Practice Address - Street 1:1020 S ARROYO PKWY
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3911
Practice Address - Country:US
Practice Address - Phone:626-403-4888
Practice Address - Fax:626-403-4894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN196410164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164X00000XNursing Service ProvidersLicensed Vocational NurseGroup - Multi-Specialty