Organization
ARROYO VISTA ADVANCED PAIN SPECIALISTS, INC.
Active
Parent organization
ARROYO VISTA ADVANCED PAIN SPECIALISTS, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
ARROYO VISTA ADVANCED PAIN SPECIALISTS, INC.
Authorized official
LANA LOUIE A. WANIA-GALICIA M.D. (PRESIDENT & CHIEF MEDICAL OFFICER)
(805) 222-4549
Entity
Organization
Contact information
Practice address
865 PATRIOT DR, SUITE 201A, MOORPARK, CA 93021-3407
(805) 222-4549
Mailing address
2980 N BEVERLY GLEN CIR, SUITE 301, LOS ANGELES, CA 90077-1726
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
A80078
CA
Other
Enumeration date
11/18/2013
Last updated
11/18/2013
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