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General NPI Number Information
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NPI Number | 1730572108
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Entity Type | Organization
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Legal Business Name | CENTERS FOR COMPREHENSIVE PAIN CARE INC
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Dates
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Enumeration Date | 03/10/2015
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Last Update Date | 03/10/2015
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Provider Practice Location Address
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Address Line | 3755 ORANGE PL STE 101
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City | BEACHWOOD
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State | OH
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Zip | 44122-4426
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Country | US
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Telephone | 216-593-0030
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Fax | 216-593-0031
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Provider Business Mailing Address
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Address Line | 3755 ORANGE PL STE 101
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City | BEACHWOOD
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State | OH
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Zip | 44122-4426
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Country | US
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Telephone | 216-593-0030
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Fax | 216-593-0031
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JEROME B YOKIEL
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Credential | M.D.
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Telephone | 216-593-0030
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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 | 35059140
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License Number State | OH
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