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Organization

REGIONAL PAIN TREATMENT CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CRIS MARQUEZ CANCHOLA (MANAGEMENT CONSULTANT)
(858) 345-7260
Entity
Organization

Contact information

Practice address
295 IMPERIAL HWY, SUITE 100, FULLERTON, CA 92835-1020
(858) 345-7260
Mailing address
295 IMPERIAL HWY, SUITE 100, FULLERTON, CA 92835-1020
(858) 345-7260

Taxonomy

Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
G59013
CA

Other

Enumeration date
03/28/2014
Last updated
03/28/2014
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