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Organization
PAIN DIAGNOSIS & TREATMENT INC., A MEDICAL CLINIC
Active
Organization
PAIN DIAGNOSIS & TREATMENT INC., A MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TERRI WICKMAN (BILLER)
(626) 857-7400
Entity
Organization
Contact information
Practice address
10630 DOWNEY AVE, SUITE 102, DOWNEY, CA 90241-3463
(562) 861-5170
Mailing address
210 S GRAND AVE, SUITE 315, GLENDORA, CA 91741-4205
(626) 857-7400
(626) 857-7404
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
A020970
CA
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
A43746
CA
Other
Enumeration date
12/06/2007
Last updated
01/12/2011
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