Provider Demographics
NPI:1821447111
Name:PAIN AND SPINE CLINICS PLLC
Entity Type:Organization
Organization Name:PAIN AND SPINE CLINICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:ABBASIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-565-7246
Mailing Address - Street 1:16620 N 40TH ST STE D1
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-3350
Mailing Address - Country:US
Mailing Address - Phone:480-565-7246
Mailing Address - Fax:602-296-5400
Practice Address - Street 1:16620 N 40TH ST
Practice Address - Street 2:STE D1
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-3348
Practice Address - Country:US
Practice Address - Phone:602-350-0491
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-07
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ32182207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty