Provider Demographics
NPI:1700258597
Name:VERDOLIN MEDICOLEGAL CONSULTING INC.
Entity Type:Organization
Organization Name:VERDOLIN MEDICOLEGAL CONSULTING INC.
Other - Org Name:PAIN CONSULTANTS OF SAN DIEGO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:VERDOLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-625-1144
Mailing Address - Street 1:7051 ALVARADO RD
Mailing Address - Street 2:101
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-8901
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7051 ALVARADO RD
Practice Address - Street 2:101
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-8901
Practice Address - Country:US
Practice Address - Phone:619-625-1144
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-20
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty