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Organization

NOR CAL PAIN MANAGEMENT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
EDUARDO ANGUIZOLA MD (MEDICAL DIRECTOR)
(877) 882-9832
Entity
Organization

Contact information

Practice address
5900 SHATTUCK AVE STE 201, OAKLAND, CA 94609-1461
(877) 882-9832
(909) 380-7741
Mailing address
5900 SHATTUCK AVE STE 201, OAKLAND, CA 94609-1461
(877) 882-9832
(909) 380-7741

Taxonomy

Speciality
Code
Description
License number
State
111NX0800X
Orthopedic Chiropractor
26628
CA
174400000X
Specialist
PSY6247
CA
363AM0700X
Medical Physician Assistant
Primary
A28494
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A28494
LICENSE NUMBER
CA
Enumeration date
03/29/2014
Last updated
03/29/2014
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