Provider Demographics
NPI:1518051408
Name:REBECCA KERR
Entity Type:Organization
Organization Name:REBECCA KERR
Other - Org Name:CALIFORNIA PAIN INSTITUTE A MED GRP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:KERR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-504-0632
Mailing Address - Street 1:4305 TORRANCE BLVD STE 500
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-4405
Mailing Address - Country:US
Mailing Address - Phone:103-504-0632
Mailing Address - Fax:310-642-7903
Practice Address - Street 1:4305 TORRANCE BLVD STE 500
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-4405
Practice Address - Country:US
Practice Address - Phone:310-504-0632
Practice Address - Fax:310-642-7900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADR7691Medicare PIN
CAW13624Medicare PIN