Organization
PAIN MANAGEMENT SPECIALISTS MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BORIS PILCH MD (MANAGING PARTNER)
(805) 782-8132
Entity
Organization
Contact information
Practice address
5000 SAN PALO RD, ATASCADERO, CA 93422-2481
(805) 782-8132
Mailing address
PO BOX 4659, SAN LUIS OBISPO, CA 93403-4659
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0105740
—
CA
Enumeration date
04/11/2012
Last updated
10/04/2012
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