# INTERVENTIONAL SPINE CENTER, LLC

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

## Provider details

- **NPI number:** 1730487083
- **Authorized official:** JENNIFER BALDOCK (OFFICER AND AUTHORIZED OFFICIAL)
- **Authorized official phone:** (615) 234-5954

## Contact information

- **Practice address:** 947 S ANAHEIM BLVD STE 215, ANAHEIM, CA 92805-5582
- **Practice address phone:** (949) 588-7246
- **Practice address fax:** (562) 866-7143
- **Mailing address:** PO BOX 5105, IRVINE, CA 92616-5105
- **Mailing address phone:** (949) 588-7246

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/10/2011
- **Last updated:** 03/05/2025