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1235725656 NPI number — CALIFORNIA PAIN MANAGEMENT GROUP

NPI Number: 1235725656
Health Care Provider/Practitioner: CALIFORNIA PAIN MANAGEMENT GROUP

Information about “1235725656” NPI (CALIFORNIA PAIN MANAGEMENT GROUP) exists in 1235725656 in HTML format HTML  |  1235725656 in plain Text format TXT  |  1235725656 in PDF (Portable Document Format) PDF  |  1235725656 in an XML format XML  formats.

NPI Number : 1235725656 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1235725656",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "CALIFORNIA PAIN MANAGEMENT GROUP",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1711 OAKBROOK LN",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SANTA MARIA",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "93455-4593",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "213-408-6284",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2727 W OLYMPIC BLVD STE 209",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LOS ANGELES",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "90006-2640",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "213-408-6284",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "12/19/2020",
    "LastUpdateDate": "08/29/2021",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "CHANG",
    "AuthorizedOfficialFirstName": "INHWAN",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "PRESIDENT",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "MD",
    "AuthorizedOfficialTelephoneNumber": "213-408-6284",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207L00000X",
          "TaxonomyName": "Anesthesiology Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "208VP0000X",
          "TaxonomyName": "Pain Medicine Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        }
      ]
    }
  }
}
                
            

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