Organization
PAIN AND REHABILITATIVE CONSULTANTS MEDICAL GROUP
Active
Organization
PAIN AND REHABILITATIVE CONSULTANTS MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BABAK JAHROMI JAMASBI M.D. (PRESIDENT)
(510) 647-5101
Entity
Organization
Contact information
Practice address
1335 STANFORD AVE, EMERYVILLE, CA 94608-2536
(510) 647-5101
(510) 647-5105
Mailing address
1335 STANFORD AVE, EMERYVILLE, CA 94608-2536
(510) 647-5101
(510) 647-5105
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
FNP26222
CA
207LP2900X
Pain Medicine (Anesthesiology) Physician
FNP26222
CA
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
FNP26222
CA
2084P2900X
Pain Medicine (Psychiatry & Neurology) Physician
FNP26222
CA
208VP0000X
Pain Medicine Physician
FNP26222
CA
208VP0014X
Interventional Pain Medicine Physician
Primary
FNP26222
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ01113Z
BLUE SHIELD OF CALIFORNIA
CA
Enumeration date
12/27/2006
Last updated
10/08/2024
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