Provider Demographics
NPI:1457949901
Name:ERIC PASTRMAC A PROFESSIONAL CHRIO CORP
Entity Type:Organization
Organization Name:ERIC PASTRMAC A PROFESSIONAL CHRIO CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:PASTRMAC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-381-6505
Mailing Address - Street 1:1585 BAKER ST
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-3746
Mailing Address - Country:US
Mailing Address - Phone:714-381-6505
Mailing Address - Fax:
Practice Address - Street 1:17207 BUTTONWOOD ST
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-3508
Practice Address - Country:US
Practice Address - Phone:714-381-6505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-08
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility