Provider Demographics
NPI:1578199147
Name:PINNACLE PAIN & REGENERATIVE MEDICINE INC
Entity Type:Organization
Organization Name:PINNACLE PAIN & REGENERATIVE MEDICINE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:PAOLO
Authorized Official - Middle Name:
Authorized Official - Last Name:JORGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-290-3972
Mailing Address - Street 1:26051 RED CORRAL RD
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-6310
Mailing Address - Country:US
Mailing Address - Phone:949-290-3972
Mailing Address - Fax:562-786-8613
Practice Address - Street 1:24452 HEALTH CENTER DR
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-3604
Practice Address - Country:US
Practice Address - Phone:949-290-3972
Practice Address - Fax:562-786-8613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-16
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty