Organization
ADVANCED PAIN MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACKIE SARIAN (PRACTICE ADMINISTRATOR)
(818) 348-7246
Entity
Organization
Contact information
Practice address
16055 VENTURA BLVD STE 444, ENCINO, CA 91436-2601
(818) 348-7246
(818) 348-7248
Mailing address
7230 MEDICAL CENTER DR STE 500, WEST HILLS, CA 91307-4024
(818) 348-7246
(818) 348-7248
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W20823
PTAN
CA
Enumeration date
10/23/2018
Last updated
03/29/2019
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