# INTERVENTIONAL SPINE CARE & ORTHOPEDIC REGENERATIVE EXPERTS

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

## Provider details

- **NPI number:** 1427509033
- **Authorized official:** DR. MAXIM MORADIAN M.D. (OWNER/PRESIDENT)
- **Authorized official phone:** (818) 913-9356

## Contact information

- **Practice address:** 800 S CENTRAL AVE STE 301, GLENDALE, CA 91204-4388
- **Practice address phone:** (818) 338-6860
- **Practice address fax:** (888) 425-9079
- **Mailing address:** PO BOX 8232, LA CRESCENTA, CA 91224-0232
- **Mailing address phone:** (818) 913-9356
- **Mailing address fax:** (818) 369-7177

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | 118692 | CA | Yes |
| 2081S0010X | Sports Medicine (Physical Medicine & Rehabilitation) Physician | 118692 | CA | — |
| 208VP0014X | Interventional Pain Medicine Physician | A118692 | CA | — |

## Other

- **Enumeration date:** 10/18/2016
- **Last updated:** 03/24/2021