Provider Demographics
NPI:1346616695
Name:NUVATION PAIN GROUP
Entity Type:Organization
Organization Name:NUVATION PAIN GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:H
Authorized Official - Last Name:LIM
Authorized Official - Suffix:
Authorized Official - Credentials:DO, MPH
Authorized Official - Phone:714-676-5541
Mailing Address - Street 1:5832 BEACH BLVD UNIT 210
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621-5501
Mailing Address - Country:US
Mailing Address - Phone:714-676-5541
Mailing Address - Fax:714-676-5542
Practice Address - Street 1:5832 BEACH BLVD UNIT 208
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90621-5501
Practice Address - Country:US
Practice Address - Phone:714-676-5541
Practice Address - Fax:714-676-5542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-20
Last Update Date:2020-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty