Provider Demographics
NPI:1306253687
Name:PACIFIC ACCOUNTABLE CARE NETWORK INC
Entity type:Organization
Organization Name:PACIFIC ACCOUNTABLE CARE NETWORK INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIPPE
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:QUILICI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-848-8311
Mailing Address - Street 1:201 S BUENA VISTA ST
Mailing Address - Street 2:SUITE 425
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-4569
Mailing Address - Country:US
Mailing Address - Phone:818-848-8311
Mailing Address - Fax:818-953-9366
Practice Address - Street 1:201 S BUENA VISTA ST
Practice Address - Street 2:SUITE 425
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4569
Practice Address - Country:US
Practice Address - Phone:818-848-8311
Practice Address - Fax:818-953-9366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-17
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty