| Pacific Clinics Gladstone High School | |
|
1340 N Enid Ave Covina CA 91722-1214 | |
| (626) 815-3619 | |
| Not Available |
| Full Name | Pacific Clinics Gladstone High School |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1340 N Enid Ave, Covina, California |
| Authorized Official Name and Position | James J. Balla (PRESIDENT & CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 6262545000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pacific Clinics Gladstone High School 800 S Santa Anita Ave Arcadia CA 91006-6853 Ph: (626) 254-5000 | Pacific Clinics Gladstone High School 1340 N Enid Ave Covina CA 91722-1214 Ph: (626) 815-3619 |
| NPI Number | 1780873935 |
|---|---|
| Provider Enumeration Date | 10/23/2007 |
| Last Update Date | 08/30/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780873935 | NPI | - | NPPES |
| 6843 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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