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CANYON PAIN AND SPINE NPI 1104590512


NPI Information

NPI: 1104590512
Provider Name: CANYON PAIN AND SPINE
Classification: Pain Medicine - 208VP0014X
Entity Type: Organization

Specialization: Interventional Pain Medicine

CLIA Number: 03D2222230

Address:
6320 W UNION HILLS DR STE A270
GLENDALE, AZ
ZIP 85308
Phone: (480) 561-5000
Get Directions

CANYON PAIN AND SPINE is an interventional pain medicine pain medicine in Glendale, AZ. The provider is interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. CANYON PAIN AND SPINE NPI is 1104590512. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

6320 W UNION HILLS DR STE A270
GLENDALE, AZ
ZIP 85308-175
Phone: (480) 561-5000

The provider's authorized official is Kirk George Bowden .
The authorized official title is Owner and has the following contact phone number (480) 889-0255.

The CLIA number assigned to this NPI record is 03D2222230 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/9/2021 and was last updated on 8/9/2021.


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
1207L00000XAnesthesiologyNo
2207LP2900XAnesthesiologyPain MedicineNo
3208VP0000XPain MedicinePain MedicineNo
4208VP0014XPain MedicineInterventional Pain MedicineYes

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.