Provider Demographics
NPI:1669291100
Name:PACIFIC CLINIC PLLC
Entity type:Organization
Organization Name:PACIFIC CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER, PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:AMIT
Authorized Official - Middle Name:
Authorized Official - Last Name:GROVER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-363-2875
Mailing Address - Street 1:1600 116TH AVE NE STE 104
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3055
Mailing Address - Country:US
Mailing Address - Phone:425-449-5660
Mailing Address - Fax:425-449-5944
Practice Address - Street 1:1600 116TH AVE NE STE 104
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3055
Practice Address - Country:US
Practice Address - Phone:425-449-5660
Practice Address - Fax:425-449-5944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-09
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty