Provider Demographics
NPI:1407486905
Name:INTEGRATIVE PHYSICAL MEDICINE PHYSICIANS
Entity Type:Organization
Organization Name:INTEGRATIVE PHYSICAL MEDICINE PHYSICIANS
Other - Org Name:INTEGRATIVE SPORTS AND SPINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF CLINIC OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:HEZHONG
Authorized Official - Middle Name:
Authorized Official - Last Name:QI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:833-476-7377
Mailing Address - Street 1:9080 IRVINE CENTER DR
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-4658
Mailing Address - Country:US
Mailing Address - Phone:833-476-7377
Mailing Address - Fax:
Practice Address - Street 1:9080 IRVINE CENTER DR
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-4658
Practice Address - Country:US
Practice Address - Phone:833-476-7377
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-23
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty