Organization
SAN DIEGO SPINE & PAIN CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LANETTE V. BUMGARDNER (OWNER/CEO)
(310) 594-5640
Entity
Organization
Contact information
Practice address
13029 POMERADO RD, SUITE C, POWAY, CA 92064-4246
(858) 312-5016
(858) 312-5018
Mailing address
13029 POMERADO RD, SUITE C, POWAY, CA 92064-4246
(858) 312-5016
(858) 312-5018
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
07/11/2016
Last updated
07/11/2016
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