# LA PHYSIATRISTS PROFESSIONAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** LOS ANGELES PAIN & WELLNESS INSTITUTE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558316984
- **Authorized official:** DR. JORGE DAMIAN MINOR M.D. (PRESIDENT)
- **Authorized official phone:** (213) 482-1046

## Contact information

- **Practice address:** 1245 WILSHIRE BLVD, SUITE 403, LOS ANGELES, CA 90017-4810
- **Practice address phone:** (213) 482-1046
- **Practice address fax:** (213) 482-4811
- **Mailing address:** 1245 WILSHIRE BLVD, SUITE 403, LOS ANGELES, CA 90017-4810
- **Mailing address phone:** (213) 482-1046
- **Mailing address fax:** (213) 482-4811

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TC0700X | Clinical Psychologist | — | NULL | — |
| 103TC0700X | Clinical Psychologist | — | — | — |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | Yes |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | — | Yes |
| 363AM0700X | Medical Physician Assistant | — | NULL | — |
| 363AM0700X | Medical Physician Assistant | — | — | — |

## Other

- **Enumeration date:** 05/24/2006
- **Last updated:** 10/25/2007