# PACIFIC SPINE & JOINT MEDICAL GROUP

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

## Provider details

- **NPI number:** 1437421336
- **Authorized official:** DR. MOSHE MILLER LEWIS MD (VICE PRESIDENT)
- **Authorized official phone:** (415) 377-7368

## Contact information

- **Practice address:** 1618 SULLIVAN AVE, SUITE \#208, DALY CITY, CA 94015-1967
- **Practice address phone:** (650) 994-4444
- **Practice address fax:** (650) 994-3051
- **Mailing address:** 1618 SULLIVAN AVE, SUITE \#208, DALY CITY, CA 94015-1967
- **Mailing address phone:** (650) 994-4444
- **Mailing address fax:** (650) 994-3051

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | A90204 | CA | Yes |

## Other

- **Enumeration date:** 02/07/2012
- **Last updated:** 04/10/2012