Provider Demographics
NPI:1821389818
Name:PACIFIC COMPREHENSIVE PAIN MANAGEMENT, INC
Entity Type:Organization
Organization Name:PACIFIC COMPREHENSIVE PAIN MANAGEMENT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-799-3888
Mailing Address - Street 1:2980 N BEVERLY GLEN CIR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90077-1726
Mailing Address - Country:US
Mailing Address - Phone:310-474-9809
Mailing Address - Fax:
Practice Address - Street 1:10861 CHERRY ST
Practice Address - Street 2:SUITE 308
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-5402
Practice Address - Country:US
Practice Address - Phone:562-799-3888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PACIFIC COMPREHENSIVE PAIN MANAGEMENT, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-04-25
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site