Healthcare Provider Details

I. General information

NPI: 1891550794
Provider Name (Legal Business Name): PAIN AND REHAB CONSULTANTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2024
Last Update Date: 04/30/2024
Certification Date: 04/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3751 MOTOR AVE UNIT 34619
LOS ANGELES CA
90034-8027
US

IV. Provider business mailing address

3751 MOTOR AVE UNIT 34619
LOS ANGELES CA
90034-8027
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 2
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: 424-301-7090