Basic Information
| Provider Information | |||||||||
| NPI: | 1447280722 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | PACIFIC FAMILY HEALTH, INC. | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | ORCHARD MEDICAL CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3475 W SHAW AVE STE 102 | ||||||||
| Address2: | 3475 W SHAW AVE STE 102 | ||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937113200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5592521932 | ||||||||
| FaxNumber: | 5594563070 | ||||||||
| Practice Location | |||||||||
| Address1: | 3475 W SHAW AVE STE 102 | ||||||||
| Address2: | 3475 W SHAW AVE STE 102 | ||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937113200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5592521932 | ||||||||
| FaxNumber: | 5594563070 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/03/2006 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | GARCIA | ||||||||
| AuthorizedOfficialFirstName: | PEDRO | ||||||||
| AuthorizedOfficialMiddleName: | VASQUEZ | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 5592521932 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | PACIFIC FAMILY HEALTH | ||||||||
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| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | NONE | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 343900000X | CA | N | Transportation Services | Non-emergency Medical Transport (VAN) | 261QP2300X | CA | Y | Ambulatory Health Care Facilities | Clinic/Center | Primary Care |
No ID Information.