Organization
PAIN CARE PROVIDERS A PROFESSIONAL MEDICAL CORPORATION
Active
Organization
PAIN CARE PROVIDERS A PROFESSIONAL MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMIR BAHRAM RAFIZAD M. D. (PRESIDENT)
(949) 872-2400
Entity
Organization
Contact information
Practice address
113 WATERWORKS WAY, SUITE 345, IRVINE, CA 92618-3167
(949) 872-2400
(949) 872-2401
Mailing address
PO BOX 54788, IRVINE, CA 92619-4788
(949) 872-2400
(949) 872-2401
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
A81189
CA
207LP2900X
Pain Medicine (Anesthesiology) Physician
A81189
CA
208VP0014X
Interventional Pain Medicine Physician
Primary
A81189
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC3554
RAILROAD MEDICARE
CA
01
—
W18108
MEDICARE
CA
Enumeration date
12/20/2006
Last updated
12/20/2016
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