Provider Demographics
NPI:1114010600
Name:SAN DIEGO PAIN REHAB
Entity Type:Organization
Organization Name:SAN DIEGO PAIN REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANKLIN
Authorized Official - Middle Name:H
Authorized Official - Last Name:DULIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-477-1700
Mailing Address - Street 1:3200 HIGHLAND AVE.
Mailing Address - Street 2:STE 203
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950
Mailing Address - Country:US
Mailing Address - Phone:619-477-1700
Mailing Address - Fax:619-477-7133
Practice Address - Street 1:3200 HIGHLAND AVE.
Practice Address - Street 2:STE 203
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950
Practice Address - Country:US
Practice Address - Phone:619-477-1700
Practice Address - Fax:619-477-7133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA41883204C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports MedicineGroup - Single Specialty