Organization
INTERVENTIONAL SPINE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER BALDOCK (OFFICER AND AUTHORIZED OFFICIAL)
(615) 234-5954
Entity
Organization
Contact information
Practice address
24012 CALLE DE LA PLATA, SUITE 130, LAGUNA HILLS, CA 92653
(949) 588-7246
(877) 854-7581
Mailing address
PO BOX 5105, IRVINE, CA 92616-5105
(949) 836-7665
(877) 854-7581
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
FNP40048
CA
Other
Enumeration date
10/26/2016
Last updated
03/08/2023
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