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General NPI Number Information
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NPI Number | 1447204110
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Entity Type | Organization
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Legal Business Name | PAIN INSTITUTE OF CALIFORNIA, INC.
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 08/09/2023
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Provider Practice Location Address
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Address Line | 9802 STOCKDALE HWY STE 105
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City | BAKERSFIELD
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State | CA
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Zip | 93311-3653
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Country | US
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Telephone | 661-665-7880
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Fax | 661-665-7881
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Provider Business Mailing Address
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Address Line | 9802 STOCKDALE HWY STE 105
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City | BAKERSFIELD
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State | CA
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Zip | 93311-3653
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Country | US
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Telephone | 661-665-7880
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Fax | 661-665-7881
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Authorized Official
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Title or Position | CMC
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Name | CHRISTY SUE SUDSBURY
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Credential |
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Telephone | 661-665-7880
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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 | G79244
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License Number State | CA
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