MEDICARE: COMPREHENSIVE PAIN & SPORTS REHABILITATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician
2	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician

General Provider Information

NPI Number	:	1427089176
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPREHENSIVE PAIN & SPORTS REHABILITATION

Provider Business Mailing Address
First Line	:	PO BOX 3129
Second Line	:
City	:	TORRANCE
State	:	CA
Zip	:	90510-3129
Country	:	US
Telephone Number	:	310-792-3914
Fax Number	:	855-898-4055

Provider Business Practice Location Address
First Line	:	1200 ROSECRANS AVE STE 202
Second Line	:
City	:	MANHATTAN BEACH
State	:	CA
Zip	:	90266-2470
Country	:	US
Telephone Number	:	310-618-9922
Fax Number	:	888-618-2660

Authorized Official
Title or Position	:	OWNER
Name	:	JOSEPH CARL PECK
Credential	:	M.D
Telephone Number	:	310-618-9922

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	04/10/2024

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Directions to “COMPREHENSIVE PAIN & SPORTS REHABILITATION ” Practice Location

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