MEDICARE: COMPREHENSIVE PAIN MEDICAL CENTER, 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
1	208100000X	Physical Medicine & Rehabilitation Physician	20A10790	CA
2	2081S0010X	Sports Medicine (Physical Medicine & Rehabilitation) Physician	20A10790	CA
3	208VP0014X	Interventional Pain Medicine Physician	20A10790	CA
4	261QM1300X	Multi-Specialty Clinic/Center
5	261QP3300X	Pain Clinic/Center
6	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician	20A10790	CA

General Provider Information

NPI Number	:	1215357561
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPREHENSIVE PAIN MEDICAL CENTER, INC

Provider Business Mailing Address
First Line	:	1081 MARKET PL STE 600
Second Line	:
City	:	SAN RAMON
State	:	CA
Zip	:	94583-4750
Country	:	US
Telephone Number	:	925-401-7113
Fax Number	:	855-422-2762

Provider Business Practice Location Address
First Line	:	1081 MARKET PL STE 600
Second Line	:
City	:	SAN RAMON
State	:	CA
Zip	:	94583-4750
Country	:	US
Telephone Number	:	925-401-7113
Fax Number	:	855-422-2762

Authorized Official
Title or Position	:	PHYSICIAN OWNER
Name	:	DR. JAMES HAN
Credential	:
Telephone Number	:	925-401-7113

Provider Enumeration Date	:	04/24/2014
Last Update Date	:	12/23/2024

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