Basic Information
| Provider Information | |||||||||
| NPI: | 1295009322 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | US PAIN, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2415 CAMPUS DR | ||||||||
| Address2: | SUITE 110 | ||||||||
| City: | IRVINE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926121527 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9499993602 | ||||||||
| FaxNumber: | 9499993648 | ||||||||
| Practice Location | |||||||||
| Address1: | 450 NEWPORT CENTER DR | ||||||||
| Address2: | SUITE 650 | ||||||||
| City: | NEWPORT BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926607610 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9499993602 | ||||||||
| FaxNumber: | 9499993648 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/07/2012 | ||||||||
| LastUpdateDate: | 03/07/2012 | ||||||||
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| AuthorizedOfficialLastName: | RAGSDALE | ||||||||
| AuthorizedOfficialFirstName: | CINDY | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO, TRUSTEE | ||||||||
| AuthorizedOfficialTelephone: | 9499993602 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208VP0014X | G53385 | CA | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pain Medicine | Interventional Pain Medicine | 2083X0100X | G35503 | CA | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Preventive Medicine | Occupational Medicine |
No ID Information.