Healthcare Provider Details

I. General information

NPI: 1568218436
Provider Name (Legal Business Name): PAIN AND REHAB CONSULTANTS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2024
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8821 AVIATION BLVD UNIT 88070
LOS ANGELES CA
90009-3495
US

IV. Provider business mailing address

8821 AVIATION BLVD # 80070
LOS ANGELES CA
90009-3739
US

V. Phone/Fax

Practice location:
  • Phone: 424-301-7090
  • Fax: 310-602-6759
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RAJ DESAI
Title or Position: PRESIDENT
Credential: MD
Phone: 848-228-0612