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General NPI Number Information
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NPI Number | 1528333614
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Entity Type | Organization
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Legal Business Name | PREMIERE PAIN CENTER, INC
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Dates
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Enumeration Date | 03/21/2012
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Last Update Date | 06/26/2012
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Provider Practice Location Address
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Address Line | 47 E ROMIE LN
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City | SALINAS
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State | CA
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Zip | 93901-3123
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Country | US
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Telephone | 831-759-0858
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Fax | 831-758-2243
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Provider Business Mailing Address
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Address Line | 47 E ROMIE LN
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City | SALINAS
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State | CA
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Zip | 93901-3123
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Country | US
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Telephone | 831-759-0858
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Fax | 831-758-2243
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. TIFFANY SMITH
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Credential |
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Telephone | 831-759-0858
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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 | A70500
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License Number State | CA
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