Organization
ADVANCED INTERVENTIONAL PAIN CENTER LA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATTANAM SRINIVASAN M.D. (CLINICAL DIRECTOR)
(424) 781-5414
Entity
Organization
Contact information
Practice address
11645 WILSHIRE BLVD, SUITE 852, LOS ANGELES, CA 90025-6808
(310) 272-9630
Mailing address
11645 WILSHIRE BLVD, SUITE 852, LOS ANGELES, CA 90025-6808
(310) 272-9630
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
C53502
CA
Other
Enumeration date
03/29/2012
Last updated
03/29/2012
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