Organization
PACIFIC SURGICAL INSTITUTE OF PAIN MANAGEMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW D RIFAT ATTY (ADMINISTRATOR)
(619) 282-0216
Entity
Organization
Contact information
Practice address
3703 CAMINO DEL RIO SOUTH, SUITE 101, SAN DIEGO, CA 92108
(619) 640-1555
(619) 640-9581
Mailing address
3703 CAMINO DEL RIO SOUTH, SUITE 101, SAN DIEGO, CA 92108
(619) 640-1555
(619) 640-9581
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
090000607
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
090000607
STATE OF CALIF DHS
CA
Enumeration date
11/14/2006
Last updated
01/28/2016
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