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General NPI Number Information
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NPI Number | 1235511833
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Entity Type | Organization
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Legal Business Name | AMERICAN SPINE PC
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Dates
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Enumeration Date | 06/19/2015
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Last Update Date | 06/19/2015
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Provider Practice Location Address
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Address Line | 31565 RANCHO PUEBLO RD SUITE #102
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City | TEMECULA
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State | CA
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Zip | 92592-4838
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Country | US
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Telephone | 951-734-7246
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Fax | 877-694-3331
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Provider Business Mailing Address
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Address Line | PO BOX 3098
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City | TORRANCE
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State | CA
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Zip | 90510-3098
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Country | US
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Telephone | 310-792-3914
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Fax | 855-898-4055
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Authorized Official
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Title or Position | PRESIDENT & FOUNDER
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Name | MR. KHURAM SIAL
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Credential | M.D.
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Telephone | 951-734-7246
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State | CA
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