VICTOR LI MD A PROFESSIONAL MEDICAL NPI 1538227897

NPI Information

NPI: 1538227897
Provider Name: VICTOR LI MD A PROFESSIONAL MEDICAL

Doing Business As: PRIME PAIN MEDICINE INSTITUTE

Classification: Anesthesiology - 207LA0401X
Entity Type: Organization

Specialization: Addiction Medicine

Address:
4140 JADE ST
SUITE 102
CAPITOLA, CA
ZIP 95010
Phone: (831) 464-7246
Get Directions

VICTOR LI MD A PROFESSIONAL MEDICAL is an addiction medicine anesthesiology in Capitola, CA. The provider is an anesthesiologist who specializes in the diagnosis and treatment of addictions. VICTOR LI MD A PROFESSIONAL MEDICAL NPI is 1538227897. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Prime Pain Medicine Institute.

The provider's business location address is:

4140 JADE ST
SUITE 102
CAPITOLA, CA
ZIP 95010-956
Phone: (831) 464-7246
Fax: (831) 576-2016

The provider's authorized official is Victor Li .
The authorized official title is Md and has the following contact phone number (831) 464-7246.

The CLIA number assigned to this NPI record is 05D1094950 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/5/2006 and was last updated on 10/30/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207LA0401X	Anesthesiology	Addiction Medicine	A77617	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00A776170	OTHER	CALIFORNIA	BLUE SHIELD
2	A77617	OTHER	CALIFORNIA	BLUE CROSS
3	00A776170	MEDICAID	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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