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General NPI Number Information
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NPI Number | 1699801290
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Entity Type | Organization
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Legal Business Name | PAIN MEDICINE & INTERVENTIONS A PROFESSIONAL MEDICAL CORPORATION
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 02/23/2015
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Provider Practice Location Address
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Address Line | 231 GREEN VALLEY RD UNIT C
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City | FREEDOM
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State | CA
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Zip | 95019-3140
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Country | US
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Telephone | 831-722-7246
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Fax | 831-722-1668
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Provider Business Mailing Address
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Address Line | PO BOX 3379
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City | FREEDOM
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State | CA
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Zip | 95019-3379
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Country | US
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Telephone | 831-722-7246
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Fax | 831-722-1668
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Authorized Official
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Title or Position | MD
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Name | DR. PEILIN CHANG
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Credential | MD
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Telephone | 831-722-7246
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 00A061036
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License Number State | CA
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