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NPI Code Detail

MEDICARE: PAINCARE MEDICAL GROUP, INC.

MEDICARE: PAINCARE MEDICAL GROUP, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP3300XPain Clinic/Center

General Provider Information

NPI Number : 1083691331
Entity Type Code : Organization
Provider Name (Legal Business Name) : PAINCARE MEDICAL GROUP, INC.
Provider Business Mailing Address
First Line : 15701 ROCKFIELD BLVD
Second Line :
City : IRVINE
State : CA
Zip : 92618-2801
Country : US
Telephone Number : 949-457-9900
Fax Number : 949-457-9922
Provider Business Practice Location Address
First Line : 15701 ROCKFIELD BLVD
Second Line :
City : IRVINE
State : CA
Zip : 92618-2801
Country : US
Telephone Number : 949-457-9900
Fax Number : 949-457-9922
Authorized Official
Title or Position : CEO
Name : DR. LARRY C HO
Credential : M.D.
Telephone Number : 949-457-9900
Provider Enumeration Date : 12/28/2005
Last Update Date : 08/22/2020

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Directions to “PAINCARE MEDICAL GROUP, INC. ” Practice Location

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