# SPINE AND PAIN CENTER INC

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

## Provider details

- **NPI number:** 1679100622
- **Authorized official:** BAO THAI NGIUYEN MD (PRESIDENT)
- **Authorized official phone:** (424) 488-0500

## Contact information

- **Practice address:** 555 PIER AVE STE 1A, HERMOSA BEACH, CA 90254-3800
- **Practice address phone:** (424) 488-0500
- **Practice address fax:** (424) 488-0498
- **Mailing address:** PO BOX 3129, TORRANCE, CA 90510-3129
- **Mailing address phone:** (310) 792-3914
- **Mailing address fax:** (855) 898-4055

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | — |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | Yes |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/26/2020
- **Last updated:** 04/03/2020