Healthcare Provider Details

I. General information

NPI: 1790267821
Provider Name (Legal Business Name): PRECISION PAIN CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2018
Last Update Date: 09/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2115 COMPTON AVE
CORONA CA
92881-7272
US

IV. Provider business mailing address

2115 COMPTON AVE
CORONA CA
92881-7272
US

V. Phone/Fax

Practice location:
  • Phone: 951-280-7888
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number20A10374
License Number StateCA

VIII. Authorized Official

Name: DR. DAVID AZER
Title or Position: PRESIDENT
Credential: DO
Phone: 951-280-7888