Provider Demographics
NPI:1316404262
Name:ADVANCED PAIN DIAGNOSTIC & SOLUTIONS, INC.
Entity Type:Organization
Organization Name:ADVANCED PAIN DIAGNOSTIC & SOLUTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:KAYVAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:HADDADAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-953-7571
Mailing Address - Street 1:729 SUNRISE AVE STE 611
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-4548
Mailing Address - Country:US
Mailing Address - Phone:916-953-7571
Mailing Address - Fax:916-771-8515
Practice Address - Street 1:1921 SYCAMORE LN
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-0844
Practice Address - Country:US
Practice Address - Phone:916-953-7571
Practice Address - Fax:916-771-8515
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADVANCED PAIN DIAGNOSTIC & SOLUTIONS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-02-27
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty