Organization
EAST BAY PAIN MANAGEMENT CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAN JARDIN (PRESIDENT)
(925) 250-7447
Entity
Organization
Contact information
Practice address
7351 BRENTWOOD BLVD, SUITE A, BRENTWOOD, CA 94513-7313
(925) 516-5656
(925) 516-5943
Mailing address
7351 BRENTWOOD BLVD, SUITE A, BRENTWOOD, CA 94513-7313
(925) 516-5656
(925) 516-5943
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
DC25146
CA
207LP2900X
Pain Medicine (Anesthesiology) Physician
A128252
CA
208VP0000X
Pain Medicine Physician
Primary
A128252
CA
208VP0014X
Interventional Pain Medicine Physician
A128252
CA
Other
Enumeration date
10/07/2014
Last updated
10/07/2014
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