Provider Demographics
NPI:1891080164
Name:TRI COUNTY PAIN MANAGEMENT CENTER INC
Entity Type:Organization
Organization Name:TRI COUNTY PAIN MANAGEMENT CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DARIN
Authorized Official - Middle Name:CHRISTAFORE
Authorized Official - Last Name:GRIGORIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:530-885-6975
Mailing Address - Street 1:410 AUBURN FOLSOM ROAD
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603
Mailing Address - Country:US
Mailing Address - Phone:530-885-6975
Mailing Address - Fax:530-885-3871
Practice Address - Street 1:410 AUBURN FOLSOM ROAD
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603
Practice Address - Country:US
Practice Address - Phone:530-885-6975
Practice Address - Fax:530-885-3871
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-15
Last Update Date:2012-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty