Provider Demographics
NPI:1508878034
Name:COMPREHENSIVE PAIN MANAGEMENT INSTITUTE
Entity Type:Organization
Organization Name:COMPREHENSIVE PAIN MANAGEMENT INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:J
Authorized Official - Last Name:BIJAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-587-2764
Mailing Address - Street 1:PO BOX 8108
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93290-8108
Mailing Address - Country:US
Mailing Address - Phone:559-587-2764
Mailing Address - Fax:559-746-0369
Practice Address - Street 1:440 GREENFIELD AVE
Practice Address - Street 2:STE D
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-3568
Practice Address - Country:US
Practice Address - Phone:559-587-2764
Practice Address - Fax:559-746-0369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA787710208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH14290Medicare UPIN