Organization
CHRONIC PAIN MANAGEMENT CLINIC A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN L GWARTZ MD (PRESIDENT)
(626) 610-3776
Entity
Organization
Contact information
Practice address
210 S GRAND AVE STE 315, GLENDORA, CA 91741-4284
(626) 610-3776
(626) 771-3191
Mailing address
210 S GRAND AVE STE 315, GLENDORA, CA 91741-4284
(626) 610-3776
(626) 771-3191
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
A43746
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
EE716A
PTAN
CA
Enumeration date
06/02/2010
Last updated
01/12/2011
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