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Organization
GUARDIAN HEADACHE AND PAIN MANAGEMENT INSTITUTE LLC
Active
Organization
GUARDIAN HEADACHE AND PAIN MANAGEMENT INSTITUTE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN TAIMOORAZY M.D. (AUTHORIZED OFFICIAL)
(224) 231-4363
Entity
Organization
Contact information
Practice address
3747 FRANKLIN AVE, SUITE 200, LONG BEACH, CA 90808-1334
(224) 231-4363
Mailing address
PO BOX 570, LAKE FOREST, IL 60045-0570
(224) 231-4363
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
NULL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
208VP0014X
Interventional Pain Medicine Physician
—
NULL
208VP0014X
Interventional Pain Medicine Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
—
NULL
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
03/25/2015
Last updated
03/25/2015
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