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NPI Code Detail

MEDICARE: ACTIVE PAIN RELIEF INC

MEDICARE: ACTIVE PAIN RELIEF 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
12081P2900XPain Medicine (Physical Medicine & Rehabilitation) Physician

General Provider Information

NPI Number : 1942540224
Entity Type Code : Organization
Provider Name (Legal Business Name) : ACTIVE PAIN RELIEF INC
Provider Business Mailing Address
First Line : 815 S CENTRAL AVE
Second Line : 10
City : GLENDALE
State : CA
Zip : 91204-2046
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4601 WILSHIRE BLVD
Second Line : 3RD FLOOR
City : LOS ANGELES
State : CA
Zip : 90010-3880
Country : US
Telephone Number : 323-556-3470
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : IGOR BOYARSKY
Credential : DO
Telephone Number : 323-556-3470
Provider Enumeration Date : 02/22/2013
Last Update Date : 02/22/2013

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Directions to “ACTIVE PAIN RELIEF INC ” Practice Location

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