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General NPI Number Information
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NPI Number | 1578821229
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Entity Type | Organization
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Legal Business Name | ALTERNATIVE PAIN MANAGEMENT CLINIC
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Dates
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Enumeration Date | 05/01/2012
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Last Update Date | 05/01/2012
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Provider Practice Location Address
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Address Line | 500 E COMPTON BLVD
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City | COMPTON
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State | CA
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Zip | 90221-3209
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Country | US
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Telephone | 310-537-3467
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Fax | 310-537-1966
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Provider Business Mailing Address
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Address Line | 500 E COMPTON BLVD
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City | COMPTON
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State | CA
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Zip | 90221-3209
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Country | US
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Telephone | 310-537-3467
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Fax | 310-537-1966
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DR. REUBEN A. BAKKAR
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Credential | D.C.
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Telephone | 310-537-3467
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NI0013X
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Taxonomy Name | Independent Medical Examiner Chiropractor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC16997
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License Number State | CA
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