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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