| Pacific Clinics Rancho Tay Center | |
|
9047 Arrow Rte Suite 170 Rancho Cucamonga CA 91730-4449 | |
| (909) 466-8696 | |
| (909) 948-0457 |
| Full Name | Pacific Clinics Rancho Tay Center |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 9047 Arrow Rte, Rancho Cucamonga, California |
| Authorized Official Name and Position | Susan Mandel (PRESIDENT/CEO) |
| Authorized Official Contact | 6262545000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pacific Clinics Rancho Tay Center 800 S Santa Anita Ave Arcadia CA 91006-6853 Ph: (626) 254-5000 | Pacific Clinics Rancho Tay Center 9047 Arrow Rte Suite 170 Rancho Cucamonga CA 91730-4449 Ph: (909) 466-8696 |
| NPI Number | 1306017702 |
|---|---|
| Provider Enumeration Date | 03/13/2008 |
| Last Update Date | 07/22/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306017702 | NPI | - | NPPES |
| 36D2 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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