| Pacific Clinics Bonita Family Services Center | |
|
790 E Bonita Ave Pomona CA 91767-1906 | |
| (909) 625-7207 | |
| (909) 626-1524 |
| Full Name | Pacific Clinics Bonita Family Services Center |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 790 E Bonita Ave, Pomona, 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 Bonita Family Services Center 800 S Santa Anita Ave Arcadia CA 91006-6853 Ph: (626) 254-5000 | Pacific Clinics Bonita Family Services Center 790 E Bonita Ave Pomona CA 91767-1906 Ph: (909) 625-7207 |
| NPI Number | 1528178852 |
|---|---|
| Provider Enumeration Date | 08/30/2006 |
| Last Update Date | 09/23/2021 |
| Certification Date | 09/23/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528178852 | NPI | - | NPPES |
| 19AN | Medicaid | CA | |
| 7561 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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