# ACADIA PAIN MANAGEMENT GROUP, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154630044
- **Authorized official:** DR. MICHAEL LONG TRAN M.D. (MEDICAL DIRECTOR/PRESIDENT)
- **Authorized official phone:** (707) 546-7979

## Contact information

- **Practice address:** 4704 HOEN AVE, SANTA ROSA, CA 95405-7824
- **Practice address phone:** (707) 546-7979
- **Practice address fax:** (707) 546-7667
- **Mailing address:** 4704 HOEN AVE, SANTA ROSA, CA 95405-7824
- **Mailing address phone:** (707) 546-7979
- **Mailing address fax:** (707) 546-7667

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | — |
| 208VP0000X | Pain Medicine Physician | — | NULL | Yes |
| 208VP0000X | Pain Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/27/2010
- **Last updated:** 11/04/2015