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General NPI Number Information
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NPI Number | 1972724987
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Entity Type | Organization
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Legal Business Name | AMERICAN PAIN INSTITUE SURGICAL MEDICAL CENTER INC
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 01/12/2010
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Provider Practice Location Address
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Address Line | 10610 LOWER AZUSA RD
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City | EL MONTE
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State | CA
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Zip | 91731-1210
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Country | US
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Telephone | 626-279-1855
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Fax | 626-279-9455
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Provider Business Mailing Address
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Address Line | 10610 LOWER AZUSA RD
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City | EL MONTE
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State | CA
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Zip | 91731-1210
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Country | US
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Telephone | 626-279-1855
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Fax | 626-279-9455
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Authorized Official
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Title or Position | OWNER
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Name | MIGUEL A DOMINGUEZ
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Credential | M.D.
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Telephone | 626-279-1855
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | IMQ 10174
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License Number State | CA
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