East Bay Pain Clinic INC
in Brentwood, CA. Organization (NPI-2).
NPI number1417325317
StatusActive
Last updated in NPPESSep 9, 2015
Details
- NPI
- 1417325317
- Entity type
- Organization (NPI-2)
- Legal business name
- East Bay Pain Clinic INC
- Organization subpart
- No
- Enumeration date
- Sep 9, 2015
- Last updated
- Sep 9, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208VP0000X | A128252 | CA | Yes | |
| 111N00000X | Chiropractor | DC25146 | CA | |
| 207LP2900X | Anesthesiology, Pain Medicine | A128252 | CA | |
| 208VP0014X | Pain Medicine, Interventional Pain Medicine | A128252 | CA |
Practice location
7351 Brentwood Blvd Ste ABrentwood, CA 94513-2058
Phone 925-516-5656 · Fax 925-516-5943
Mailing address
7351 Brentwood Blvd Ste ABrentwood, CA 94513-2058
Phone 925-516-5656 · Fax 925-516-5943
Authorized official
Dan Jardin
Owner
9255165656
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