Community Pain Management Medical Clinic Inc

LBN: Community Pain Management Medical Clinic Inc
Community Pain Management Medical Clinic Inc is an health care organization with primary practice located at 4500 Brockton Ave Ste 305, Riverside CA 92501-4028. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Interventional Pain Medicine, which is considered as the primary health care specialty. Community Pain Management Medical Clinic Inc can be contacted via phone (951) 715-3963, or through Maddox, Jan Paul via phone (951) 715-3963.

Contact Information

Primary practice address
4500 Brockton Ave Ste 305 Riverside CA 92501-4028
Fax: (951) 715-3960
Website:
Authorized official contact:
Name: Maddox, Jan Paul M.D.,FIPP,ABA,ABPM

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Interventional Pain Medicine 208VP0014X A32046 California

Profile Details

NPI number 1811992068
LBN Legal business name Community Pain Management Medical Clinic Inc
DBA Doing business as
Authorized official Maddox, Jan Paul M.D.,FIPP,ABA,ABPM
Entity Organization
Organization subpart 1 No
Enumeration date Jun 15th, 2005
Last updated Apr 20th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811992068 NPPES
California Other 00A320460 MEDI-CAL ID NUMBER
California Other ZZZ05981Z MEDI-CAL ID NUMBER

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