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General NPI Number Information
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NPI Number | 1306021159
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Entity Type | Organization
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Legal Business Name | ADVANCED PAIN TREATMENT MEDICAL CENTER, INC.
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Dates
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Enumeration Date | 12/28/2007
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Last Update Date | 12/28/2007
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Provider Practice Location Address
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Address Line | 1412 W 7TH ST
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City | SAN PEDRO
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State | CA
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Zip | 90732-3507
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Country | US
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Telephone | 310-548-5481
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Fax | 310-548-5000
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Provider Business Mailing Address
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Address Line | 1412 W 7TH ST
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City | SAN PEDRO
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State | CA
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Zip | 90732-3507
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Country | US
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Telephone | 310-548-5481
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Fax | 310-548-5000
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. KAMRAN GHADIMI
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Credential | M.D.
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Telephone | 310-548-5481
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number | A50028
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License Number State | CA
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