Provider Demographics
NPI:1194319905
Name:ADVANCED PAIN DIAGNOSTIC & SOLUTIONS, INC.
Entity type:Organization
Organization Name:ADVANCED PAIN DIAGNOSTIC & SOLUTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPHINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-953-7571
Mailing Address - Street 1:729 SUNRISE AVE STE 602
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-4542
Mailing Address - Country:US
Mailing Address - Phone:916-953-7571
Mailing Address - Fax:916-771-8515
Practice Address - Street 1:400 PLAZA DR STE 160
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-4746
Practice Address - Country:US
Practice Address - Phone:916-953-7571
Practice Address - Fax:916-771-8515
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADVANCED PAIN DIAGNOSTIC & SOLUTIONS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-22
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty