Provider Demographics
NPI:1336333418
Name:PACIFIC MEDICAL LLC
Entity Type:Organization
Organization Name:PACIFIC MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:E
Authorized Official - Last Name:FARLOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-294-8527
Mailing Address - Street 1:2652 MOUNTAIN VIEW DR
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92027-4933
Mailing Address - Country:US
Mailing Address - Phone:760-294-8527
Mailing Address - Fax:888-277-2957
Practice Address - Street 1:40 VIA CARTAMA
Practice Address - Street 2:
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92673-6998
Practice Address - Country:US
Practice Address - Phone:888-277-2957
Practice Address - Fax:888-277-2957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-31
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies