Provider Demographics
NPI:1861842379
Name:OASIS PAIN AND WELLNESS
Entity Type:Organization
Organization Name:OASIS PAIN AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EDUARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:925-548-9118
Mailing Address - Street 1:6155 STONERIDGE DR STE 101
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-3365
Mailing Address - Country:US
Mailing Address - Phone:925-251-9451
Mailing Address - Fax:925-251-0356
Practice Address - Street 1:6155 STONERIDGE DR STE 101
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-3365
Practice Address - Country:US
Practice Address - Phone:925-251-9451
Practice Address - Fax:925-251-0356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-15
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA53538174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA571062326Medicare UPIN