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NPI Code Detail

MEDICARE: INTEGRATED PAIN CARE INC

MEDICARE: INTEGRATED PAIN CARE 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
1207LP2900XPain Medicine (Anesthesiology) PhysicianA77502CA

General Provider Information

NPI Number : 1447517404
Entity Type Code : Organization
Provider Name (Legal Business Name) : INTEGRATED PAIN CARE INC
Provider Business Mailing Address
First Line : 3065 RICHMOND PKWY
Second Line : SUITE 101
City : RICHMOND
State : CA
Zip : 94806-5719
Country : US
Telephone Number : 415-279-7393
Fax Number : 800-806-5602
Provider Business Practice Location Address
First Line : 3065 RICHMOND PKWY
Second Line : SUITE 101
City : RICHMOND
State : CA
Zip : 94806-5719
Country : US
Telephone Number : 415-279-7393
Fax Number : 800-806-5602
Authorized Official
Title or Position : OFFICER
Name : GARY MARTINOVSKY
Credential : M.D.
Telephone Number : 415-279-7393
Provider Enumeration Date : 04/16/2012
Last Update Date : 09/13/2012

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Directions to “INTEGRATED PAIN CARE INC ” Practice Location

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