Provider Demographics
NPI:1104282441
Name:ROBERT SAVALA MD, INTERVENTIONAL PAIN MGMT CORP
Entity type:Organization
Organization Name:ROBERT SAVALA MD, INTERVENTIONAL PAIN MGMT CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDETNTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-499-5132
Mailing Address - Street 1:PO BOX 80519
Mailing Address - Street 2:
Mailing Address - City:CITY OF INDUSTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91716-8405
Mailing Address - Country:US
Mailing Address - Phone:903-787-5850
Mailing Address - Fax:
Practice Address - Street 1:2186 GEARY BLVD
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3455
Practice Address - Country:US
Practice Address - Phone:903-787-5850
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-31
Last Update Date:2016-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG078848207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherPENDING