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Organization
SPINE AND PAIN CENTER INC
Active
Organization
SPINE AND PAIN CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BAO THAI NGIUYEN MD (PRESIDENT)
(424) 488-0500
Entity
Organization
Contact information
Practice address
555 PIER AVE STE 1A, HERMOSA BEACH, CA 90254-3800
(424) 488-0500
(424) 488-0498
Mailing address
PO BOX 3129, TORRANCE, CA 90510-3129
(310) 792-3914
(855) 898-4055
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
NULL
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
Other
Enumeration date
03/26/2020
Last updated
04/03/2020
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