Provider Demographics
NPI:1275536294
Name:METROPOLITAN PAIN MANAGEMENT CONSULTANTS, INC
Entity Type:Organization
Organization Name:METROPOLITAN PAIN MANAGEMENT CONSULTANTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LEE
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:SNOOK
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:916-568-8338
Mailing Address - Street 1:2288 AUBURN BLVD
Mailing Address - Street 2:STE 106
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95821-1619
Mailing Address - Country:US
Mailing Address - Phone:916-568-8338
Mailing Address - Fax:916-925-3985
Practice Address - Street 1:2288 AUBURN BLVD
Practice Address - Street 2:STE 106
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95821-1619
Practice Address - Country:US
Practice Address - Phone:916-568-8338
Practice Address - Fax:916-925-3985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-23
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0082620Medicaid
CA6531190001OtherDMERC
CA6531190001OtherDMERC
CAZZZ15854ZMedicare ID - Type UnspecifiedMEDICARE GRP BILLING NUMB