Provider Demographics
NPI:1730117789
Name:ALLIANCE PAIN CARE
Entity Type:Organization
Organization Name:ALLIANCE PAIN CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:707-762-8586
Mailing Address - Street 1:PO BOX 7096
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95267
Mailing Address - Country:US
Mailing Address - Phone:209-956-7725
Mailing Address - Fax:209-956-7733
Practice Address - Street 1:3835 CYPRESS DRIVE
Practice Address - Street 2:SUITE 102
Practice Address - City:PETALUMA
Practice Address - State:CA
Practice Address - Zip Code:94954-6966
Practice Address - Country:US
Practice Address - Phone:707-762-8586
Practice Address - Fax:707-762-8582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-29
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A615060OtherBLUE SHIELD OF CALIFORNIA
CA200525200OtherUS DEPARTMENT OF LABOR
CAP00127835OtherRAILROAD MEDICARE
CAP00127835OtherRAILROAD MEDICARE
CA00A615060OtherBLUE SHIELD OF CALIFORNIA
CAP00127835Medicare PIN
CA00A615061Medicare PIN