Organization
GUARDIAN HEADACHE AND PAIN MANAGEMENT INSTITUTE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN TAIMOORAZY M.D. (AUTHORIZED OFFICIAL)
(224) 231-4363
Entity
Organization
Contact information
Practice address
3747 FRANKLIN AVE, SUITE 200, LONG BEACH, CA 90808-1334
(224) 231-4363
Mailing address
PO BOX 570, LAKE FOREST, IL 60045-0570
(224) 231-4363
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
03/25/2015
Last updated
03/25/2015
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