Provider Demographics
NPI:1649228495
Name:QUANG CONSULTING SERVICES, PLC
Entity Type:Organization
Organization Name:QUANG CONSULTING SERVICES, PLC
Other - Org Name:SPECTRUM PAIN MANAGEMENT, PLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:QUANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-800-3975
Mailing Address - Street 1:20701 N SCOTTSDALE RD STE 107-496
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-6499
Mailing Address - Country:US
Mailing Address - Phone:480-800-3975
Mailing Address - Fax:480-800-3982
Practice Address - Street 1:20701 N SCOTTSDALE RD STE 107-496
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-6413
Practice Address - Country:US
Practice Address - Phone:480-800-3975
Practice Address - Fax:480-800-3982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2018-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ35299208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ109653Medicare PIN