PAIN MANAGEMENT SPECIALISTS MEDICAL GROUP NPI 1265435416

NPI Information

PAIN MANAGEMENT SPECIALISTS MEDICAL GROUP is a specialist in San Luis Obispo, CA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. PAIN MANAGEMENT SPECIALISTS MEDICAL GROUP NPI is 1265435416. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Interventional Pain Management.

The provider's business location address is:

10 SANTA ROSA ST
STE 201
SAN LUIS OBISPO, CA
ZIP 93405-825
Phone: (805) 782-8132
Fax: (805) 597-8350

The provider's authorized official is Inna Gribanova .
The authorized official title is Manager and has the following contact phone number (805) 782-8132.

The CLIA number assigned to this NPI record is 05D1087052 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 5/23/2005 and was last updated on 12/29/2010.

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:

Other Identifiers

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

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.