Healthcare Provider Details

I. General information

NPI: 1508878034
Provider Name (Legal Business Name): COMPREHENSIVE PAIN MANAGEMENT INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 GREENFIELD AVE STE D
HANFORD CA
93230-3568
US

IV. Provider business mailing address

PO BOX 8108
VISALIA CA
93290-8108
US

V. Phone/Fax

Practice location:
  • Phone: 559-587-2764
  • Fax: 559-746-0369
Mailing address:
  • Phone: 559-587-2764
  • Fax: 559-746-0369

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberA787710
License Number StateCA

VIII. Authorized Official

Name: DR. GREGORY J BIJAK
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 559-587-2764