Provider Demographics
NPI:1891014973
Name:PAIN MEDICINE CONSULTANTS
Entity Type:Organization
Organization Name:PAIN MEDICINE CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:RUBEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KALRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-287-1505
Mailing Address - Street 1:100 N WIGET LN STE 160
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-5917
Mailing Address - Country:US
Mailing Address - Phone:925-287-1505
Mailing Address - Fax:
Practice Address - Street 1:100 ROWLAND WAY STE 200
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94945-5041
Practice Address - Country:US
Practice Address - Phone:415-878-0255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-27
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site
Provider Identifiers
StateIdentifier IDID TypeIssuer
1831327055OtherNPI