Healthcare Provider Details

I. General information

NPI: 1831327055
Provider Name (Legal Business Name): PAIN MEDICINE CONSULTANTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2009
Last Update Date: 06/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2250 MORELLO AVE
PLEASANT HILL CA
94523-1860
US

IV. Provider business mailing address

2250 MORELLO AVE
PLEASANT HILL CA
94523-1860
US

V. Phone/Fax

Practice location:
  • Phone: 925-287-1256
  • Fax: 925-287-0913
Mailing address:
  • Phone: 925-287-1256
  • Fax: 925-287-0913

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DR. RICHARD CRAIG SHINAMAN
Title or Position: PARTNER
Credential: M.D.
Phone: 925-287-1256