Provider Demographics
NPI:1548884059
Name:PACIFIC MEDICAL SERVICES
Entity type:Organization
Organization Name:PACIFIC MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROOBINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:KARAPETIAN
Authorized Official - Suffix:
Authorized Official - Credentials:CLS
Authorized Official - Phone:818-578-5180
Mailing Address - Street 1:9731 BOTHWELL RD
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-1612
Mailing Address - Country:US
Mailing Address - Phone:818-231-7687
Mailing Address - Fax:
Practice Address - Street 1:5620 WILBUR AVE STE 211
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-1309
Practice Address - Country:US
Practice Address - Phone:818-578-5180
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-31
Last Update Date:2020-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMTA-00026525OtherCALIFORNIA DEPARTMENT OF PUBLIC HEALTH