Organization
BEACH CITIES PAIN MANAGEMENT GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTHONY M CALLOWAY M.D. (PRESIDENT)
(310) 792-3914
Entity
Organization
Contact information
Practice address
514 N PROSPECT AVE, STE 100, REDONDO BEACH, CA 90277-3036
(310) 376-2707
(310) 798-4600
Mailing address
PO BOX 3098, TORRANCE, CA 90510-3098
(310) 792-3914
(310) 792-3802
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G66639
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G66639
CA STATE LICENSE
CA
Enumeration date
09/22/2010
Last updated
09/22/2010
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