Provider Demographics
NPI:1114383080
Name:ADVANCE COMPREHENSIVE PAIN CARE INC
Entity Type:Organization
Organization Name:ADVANCE COMPREHENSIVE PAIN CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OF CLINIC
Authorized Official - Prefix:
Authorized Official - First Name:MUNISH
Authorized Official - Middle Name:
Authorized Official - Last Name:LOOMBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-208-7700
Mailing Address - Street 1:23020 ATLANTIC CIR
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92553-5911
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:23020 ATLANTIC CIR
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92553-5911
Practice Address - Country:US
Practice Address - Phone:951-208-7700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-08
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC136636207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty