DataLabs

datalabs.health made in the usa

Contact us Sign in | Documentation |

divider

Medicare/Medicaid Verification Programs divider

divider

Medicare Verification Program divider

divider

1952466963

NPI Code Detail

MEDICARE: PAIN AND REHABILITATIVE CONSULTANTS MEDICAL GROUP

MEDICARE: PAIN AND REHABILITATIVE CONSULTANTS MEDICAL GROUP

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	207L00000X	Anesthesiology Physician	FNP26222	CA
2	207LP2900X	Pain Medicine (Anesthesiology) Physician	FNP26222	CA
3	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician	FNP26222	CA
4	2084P2900X	Pain Medicine (Psychiatry & Neurology) Physician	FNP26222	CA
5	208VP0000X	Pain Medicine Physician	FNP26222	CA
6	208VP0014X	Interventional Pain Medicine Physician	FNP26222	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ZZZ01113Z	OTHER	CA	BLUE SHIELD OF CALIFORNIA

General Provider Information

NPI Number	:	1952466963
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAIN AND REHABILITATIVE CONSULTANTS MEDICAL GROUP

Provider Business Mailing Address
First Line	:	1335 STANFORD AVE
Second Line	:
City	:	EMERYVILLE
State	:	CA
Zip	:	94608-2536
Country	:	US
Telephone Number	:	510-647-5101
Fax Number	:	510-647-5105

Provider Business Practice Location Address
First Line	:	1335 STANFORD AVE
Second Line	:
City	:	EMERYVILLE
State	:	CA
Zip	:	94608-2536
Country	:	US
Telephone Number	:	510-647-5101
Fax Number	:	510-647-5105

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BABAK JAHROMI JAMASBI
Credential	:	M.D.
Telephone Number	:	510-647-5101

Provider Enumeration Date	:	12/27/2006
Last Update Date	:	10/08/2024

Similar Medicare Providers

1710071568 — BRENDAN PATRICK MORLEY M.D.
Practice Location Address:

1335 STANFORD AVE
EMERYVILLE, CA
94608-2536

Practice Phone: 510-649-7000
Practice Fax: 510-649-7010

1689755902 — MS. RIDDHI PATEL PA
Practice Location Address:

1335 STANFORD AVE
EMERYVILLE, CA
94608-2536

Practice Phone: 510-647-5101
Practice Fax: 510-647-5105

1285790154 — DR. JESS H GHANNAM PHD
Practice Location Address:

1335 STANFORD
EMERYVILLE, CA
94608-2536

Practice Phone: 510-647-5101
Practice Fax: 510-647-5105

1194851857 — DR. TIMOTHY S. LO M.D., M.P.H.
Practice Location Address:

1335 STANFORD AVE
EMERYVILLE, CA
94608-2536

Practice Phone: 510-647-5101
Practice Fax:

1346432929 — AGNES WARHOVER PA
Practice Location Address:

1335 STANFORD AVE
EMERYVILLE, CA
94608-2536

Practice Phone: 510-647-5101
Practice Fax: 510-647-5105

1114167814 — MARK PHILLIPS
Practice Location Address:

1335 STANFORD AVE
EMERYVILLE, CA
94608-2536

Practice Phone: 510-647-5101
Practice Fax:

Directions to “PAIN AND REHABILITATIVE CONSULTANTS MEDICAL GROUP ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.