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General NPI Number Information
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NPI Number | 1669117255
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Entity Type | Organization
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Legal Business Name | SOCAL PAIN CLINICS
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Dates
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Enumeration Date | 04/28/2022
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Last Update Date | 04/28/2022
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Provider Practice Location Address
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Address Line | 1503 S COAST DR STE 303
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City | COSTA MESA
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State | CA
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Zip | 92626-1528
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Country | US
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Telephone | 310-254-9015
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Fax |
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Provider Business Mailing Address
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Address Line | 1503 S COAST DR STE 303
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City | COSTA MESA
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State | CA
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Zip | 92626-1528
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Country | US
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Telephone | 310-254-9015
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALEX SABO
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Credential |
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Telephone | 310-767-6019
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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