Provider Demographics
NPI:1851944110
Name:ONYX PAIN MANAGEMENT MEDICAL CORPORATION
Entity Type:Organization
Organization Name:ONYX PAIN MANAGEMENT MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:877-331-3878
Mailing Address - Street 1:653 CHAUCER RD
Mailing Address - Street 2:
Mailing Address - City:SAN MARINO
Mailing Address - State:CA
Mailing Address - Zip Code:91108-1309
Mailing Address - Country:US
Mailing Address - Phone:877-331-3878
Mailing Address - Fax:888-578-6188
Practice Address - Street 1:1250 S SUNSET AVE STE 206
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-3962
Practice Address - Country:US
Practice Address - Phone:877-331-3878
Practice Address - Fax:888-578-6188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-16
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain