Organization
INTERVENTIONAL SPINE CARE & ORTHOPEDIC REGENERATIVE EXPERTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAXIM MORADIAN M.D. (OWNER/PRESIDENT)
(818) 913-9356
Entity
Organization
Contact information
Practice address
800 S CENTRAL AVE STE 301, GLENDALE, CA 91204-4388
(818) 338-6860
(888) 425-9079
Mailing address
PO BOX 8232, LA CRESCENTA, CA 91224-0232
(818) 913-9356
(818) 369-7177
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
118692
CA
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
118692
CA
208VP0014X
Interventional Pain Medicine Physician
A118692
CA
Other
Enumeration date
10/18/2016
Last updated
03/24/2021
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