Healthcare Provider Details
I. General information
NPI: 1972481059
Provider Name (Legal Business Name): SEKIWALA PAIN MANAGEMENT P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/26/2025
Last Update Date: 08/26/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5000 BIRCH STREET SUITE 3000
NEWPORT BEACH CA
92660
US
IV. Provider business mailing address
3857 BIRCH STREET SUITE 3139
NEWPORT BEACH CA
92660
US
V. Phone/Fax
- Phone: 714-234-7485
- Fax: 714-701-1078
- Phone: 714-234-7485
- Fax: 714-701-1078
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208VP0000X |
| Taxonomy | Pain Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
EDWIN
SAMUEL
KULUBYA
SR.
Title or Position: PROVIDER
Credential: M.D
Phone: 714-234-7485