Provider Demographics
NPI:1922278381
Name:GLENDALE PAIN MEDICINE ASSOCIATES INC
Entity Type:Organization
Organization Name:GLENDALE PAIN MEDICINE ASSOCIATES INC
Other - Org Name:TRI-VALLEY SPINE AND PAIN CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:KHATCHIG
Authorized Official - Last Name:KAYPEKIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-409-0060
Mailing Address - Street 1:1500 S CENTRAL AVE
Mailing Address - Street 2:SUITE 126
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204-2530
Mailing Address - Country:US
Mailing Address - Phone:818-409-0060
Mailing Address - Fax:
Practice Address - Street 1:710 S CENTRAL AVE STE 340
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-4647
Practice Address - Country:US
Practice Address - Phone:818-409-0060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-01
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA86477208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty