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General NPI Number Information
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NPI Number | 1265727762
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Entity Type | Organization
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Legal Business Name | NAVARRO PAIN CONTROL GROUP INC.
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Dates
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Enumeration Date | 06/13/2011
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Last Update Date | 09/12/2018
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Provider Practice Location Address
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Address Line | 2452 FENTON STREET C101
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City | CHULA VISTA
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State | CA
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Zip | 91914-4543
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Country | US
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Telephone | 619-600-5309
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Fax | 619-655-4700
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Provider Business Mailing Address
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Address Line | 2452 FENTON STREET C101
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City | CHULA VISTA
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State | CA
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Zip | 91914-4543
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Country | US
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Telephone | 619-600-5309
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Fax | 619-655-4700
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Authorized Official
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Title or Position | PRESIDENT / OWNER
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Name | ROSA M NAVARRO
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Credential | MD
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Telephone | 619-600-5309
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | C53858
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License Number State | CA
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