Provider Demographics
NPI:1740237882
Name:PAINLESS SPINE CENTER OF PALM SPRINGS, INC
Entity Type:Organization
Organization Name:PAINLESS SPINE CENTER OF PALM SPRINGS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:
Authorized Official - Last Name:IBRAHIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-486-3555
Mailing Address - Street 1:23110 ATLANTIC CIR
Mailing Address - Street 2:SUITE F
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92553-5920
Mailing Address - Country:US
Mailing Address - Phone:951-486-3555
Mailing Address - Fax:
Practice Address - Street 1:1100 N PALM CANYON DR
Practice Address - Street 2:112
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-4414
Practice Address - Country:US
Practice Address - Phone:951-486-3555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG394492081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty