Organization
EDICO HEALTH CARE CORPORATION
Active
Other names
EDICO Pain Management and Rehabilitation Wellness Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARCIANO PINGUE TAMAYO (VP FOR OPERATIONS)
(626) 794-1570
Entity
Organization
Contact information
Practice address
1737 E. WASHINGTON BLVD., PASADENA, CA 91104
(626) 794-1570
Mailing address
1737 E WASHINGTON BLVD, PASADENA, CA 91104-2768
(626) 794-1570
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
—
—
2083P0901X
Public Health & General Preventive Medicine Physician
—
—
208D00000X
General Practice Physician
—
—
Other
Enumeration date
07/20/2009
Last updated
07/20/2009
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