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CENTRAL VALLEY PAIN MANAGEMENT AND WELLNESS CLINIC NPI 1871657403


NPI Information

NPI: 1871657403
Provider Name: CENTRAL VALLEY PAIN MANAGEMENT AND WELLNESS CLINIC

Other Name: CENTRAL VALLEY PAIN MANAGEMENT

Classification: Neuromusculoskeletal Medicine, Sports Medicine - 204C00000X
Entity Type: Organization
Address:
1300 MABLE AVENUE
SUITE 2
MODESTO, CA
ZIP 95355
Phone: (209) 571-1992
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CENTRAL VALLEY PAIN MANAGEMENT AND WELLNESS CLINIC is a neuromusculoskeletal medicine sports medicine in Modesto, CA. The provider is a Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine physician trained to be responsible for the continuous care in the field of sports medicine encompasses increased knowledge and understanding of osteopathic principles and practice and heightened technical skills of osteopathic manipulative medicine and integrates each of these into the management of the individual engaged in physical exercise (sports) whether as an individual or in team participation. Source: American Osteopathic Association Additional Resources: AOA Osteopathic Board Certification in Neuromusculoskeletal Medicine; https://certification.osteopathic.org/sports-medicine/ CENTRAL VALLEY PAIN MANAGEMENT AND WELLNESS CLINIC NPI is 1871657403. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Central Valley Pain Management.

The provider's business location address is:

1300 MABLE AVENUE
SUITE 2
MODESTO, CA
ZIP 95355-120
Phone: (209) 571-1992
Fax: (209) 571-1994

The provider's authorized official is Patrick Neal Rhoades .
The authorized official title is President and has the following contact phone number (209) 571-1992.

The enumeration date for this NPI number is 12/20/2006 and was last updated on 11/26/2012.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208VP0000XPain MedicinePain Medicine00A519490CALIFORNIANo
22081P2900XPhysical Medicine & RehabilitationPain Medicine00A519490CALIFORNIANo
3204C00000XNeuromusculoskeletal Medicine, Sports Medicine00A519490CALIFORNIAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1F66233MEDICARE UPINCALIFORNIA
200A519490MEDICAIDCALIFORNIA

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

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