Provider Demographics
NPI:1720556970
Name:PACIFIC MEDICL CENTER OF HOPE
Entity Type:Organization
Organization Name:PACIFIC MEDICL CENTER OF HOPE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-439-5393
Mailing Address - Street 1:496 OLD NEWPORT BLVD STE 107
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-4263
Mailing Address - Country:US
Mailing Address - Phone:949-515-4673
Mailing Address - Fax:949-515-4672
Practice Address - Street 1:1680 E HERNDON AVE STE 102
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3384
Practice Address - Country:US
Practice Address - Phone:559-439-5393
Practice Address - Fax:559-439-5828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-06
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty