Provider Demographics
NPI:1215357561
Name:COMPREHENSIVE PAIN MEDICAL CENTER, INC
Entity Type:Organization
Organization Name:COMPREHENSIVE PAIN MEDICAL CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:HAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-208-7947
Mailing Address - Street 1:420 MISSION BAY BLVD N
Mailing Address - Street 2:602
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94158-2165
Mailing Address - Country:US
Mailing Address - Phone:707-208-7947
Mailing Address - Fax:
Practice Address - Street 1:7901 STONERIDGE DR
Practice Address - Street 2:225
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-3677
Practice Address - Country:US
Practice Address - Phone:925-401-7113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-24
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A10790208100000X, 2081P2900X, 2081S0010X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports MedicineGroup - Multi-Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty