Organization
ACADIA PAIN MANAGEMENT GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL LONG TRAN M.D. (MEDICAL DIRECTOR/PRESIDENT)
(707) 546-7979
Entity
Organization
Contact information
Practice address
4704 HOEN AVE, SANTA ROSA, CA 95405-7824
(707) 546-7979
(707) 546-7667
Mailing address
4704 HOEN AVE, SANTA ROSA, CA 95405-7824
(707) 546-7979
(707) 546-7667
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
208VP0000X
Pain Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
EZ666A
PTAN
CA
Enumeration date
09/27/2010
Last updated
11/04/2015
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