Provider Demographics
NPI:1780824888
Name:CENTER FOR PAIN CONTROL IN CALIFORNIA-MEDICAL ASSOCIATES
Entity Type:Organization
Organization Name:CENTER FOR PAIN CONTROL IN CALIFORNIA-MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHUBHA
Authorized Official - Middle Name:M
Authorized Official - Last Name:JAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-366-0474
Mailing Address - Street 1:PO BOX 8000
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91327-8000
Mailing Address - Country:US
Mailing Address - Phone:818-366-0474
Mailing Address - Fax:818-474-7530
Practice Address - Street 1:11145 TAMPA AVE
Practice Address - Street 2:21B
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91326-2255
Practice Address - Country:US
Practice Address - Phone:818-366-0474
Practice Address - Fax:818-474-7530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-02
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA54399261QP3300X
CAA47841261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain