# CHRONIC PAIN MANAGEMENT CLINIC A MEDICAL CORPORATION

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

## Provider details

- **NPI number:** 1871813899
- **Authorized official:** BRIAN L GWARTZ MD (PRESIDENT)
- **Authorized official phone:** (626) 610-3776

## Contact information

- **Practice address:** 210 S GRAND AVE STE 315, GLENDORA, CA 91741-4284
- **Practice address phone:** (626) 610-3776
- **Practice address fax:** (626) 771-3191
- **Mailing address:** 210 S GRAND AVE STE 315, GLENDORA, CA 91741-4284
- **Mailing address phone:** (626) 610-3776
- **Mailing address fax:** (626) 771-3191

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | A43746 | CA | Yes |

## Other

- **Enumeration date:** 06/02/2010
- **Last updated:** 01/12/2011