Organization
SOFT TISSUE MEDICAL CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTHONY MICHAEL PAYAN DC (OWNER/OFFICER)
(831) 373-0188
Entity
Organization
Contact information
Practice address
648 PINE AVE, PACIFIC GROVE, CA 93950-3347
(831) 373-0188
(831) 373-6979
Mailing address
648 PINE AVE, PACIFIC GROVE, CA 93950-3347
(831) 373-0188
(831) 373-6979
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
DC19245
CA
208100000X
Physical Medicine & Rehabilitation Physician
G42005
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G420050
RWT - BS
CA
01
—
1134258825
DAP - NPI
CA
01
—
1619998960
RWT NPI
CA
01
—
DC0192450
DAP - BS
CA
01
—
DC19245
DAP - BC
CA
01
—
G42005
RWT - BC
CA
01
—
ZZZ66746Z
BLUE SHIELD
CA
Enumeration date
03/05/2007
Last updated
02/28/2018
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