# EDICO HEALTH CARE CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** EDICO Pain Management and Rehabilitation Wellness Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184854671
- **Authorized official:** MR. MARCIANO PINGUE TAMAYO (VP FOR OPERATIONS)
- **Authorized official phone:** (626) 794-1570

## Contact information

- **Practice address:** 1737 E. WASHINGTON BLVD., PASADENA, CA 91104
- **Practice address phone:** (626) 794-1570
- **Mailing address:** 1737 E WASHINGTON BLVD, PASADENA, CA 91104-2768
- **Mailing address phone:** (626) 794-1570

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |
| 2081S0010X | Sports Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | — |
| 2081S0010X | Sports Medicine (Physical Medicine & Rehabilitation) Physician | — | — | — |
| 2083P0901X | Public Health & General Preventive Medicine Physician | — | NULL | — |
| 2083P0901X | Public Health & General Preventive Medicine Physician | — | — | — |
| 208D00000X | General Practice Physician | — | NULL | — |
| 208D00000X | General Practice Physician | — | — | — |

## Other

- **Enumeration date:** 07/20/2009
- **Last updated:** 07/20/2009