# PAIN INSTITUTE OF SOUTHERN ARIZONA PISA PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PAIN INSTITUTE OF SOUTHERN ARIZONA PISA PC
- **Other names:** Regional Pain Institute, Regional Pain Institute
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1780268912
- **Legal business name:** PAIN INSTITUTE OF SOUTHERN ARIZONA PISA PC
- **Authorized official:** JENNIFER L IRWIN (CREDENTIALING MANAGER)
- **Authorized official phone:** (520) 829-6776

## Contact information

- **Practice address:** 36453 N GANTZEL RD STE 101, SAN TAN VALLEY, AZ 85140-7340
- **Practice address phone:** (480) 636-1225
- **Practice address fax:** (480) 636-8890
- **Mailing address:** 4881 E GRANT RD STE 101, TUCSON, AZ 85712-2704
- **Mailing address phone:** (520) 318-6035
- **Mailing address fax:** (520) 795-9953

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/12/2021
- **Last updated:** 05/12/2021