Healthcare Provider Details

I. General information

NPI: 1760429252
Provider Name (Legal Business Name): PAIN MANAGEMENT ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24012 CALLE DE LA PLATA STE 120
LAGUNA HILLS CA
92653-3632
US

IV. Provider business mailing address

PO BOX 4034
IRVINE CA
92616-4034
US

V. Phone/Fax

Practice location:
  • Phone: 949-588-7246
  • Fax: 866-829-7143
Mailing address:
  • Phone: 949-588-7246
  • Fax: 949-272-3746

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER BOYD BALDOCK
Title or Position: OFFICER AND AUTHORIZED OFFICIAL
Credential:
Phone: 615-234-5954