Provider Demographics
NPI:1851585301
Name:ADVANCED SPINE AND PAIN MANAGEMENT INC.
Entity type:Organization
Organization Name:ADVANCED SPINE AND PAIN MANAGEMENT INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAIMAL
Authorized Official - Middle Name:S
Authorized Official - Last Name:SANGHA
Authorized Official - Suffix:
Authorized Official - Credentials:DC, NP
Authorized Official - Phone:209-383-3090
Mailing Address - Street 1:544 W 25TH ST
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340-2828
Mailing Address - Country:US
Mailing Address - Phone:209-383-3090
Mailing Address - Fax:209-383-3091
Practice Address - Street 1:544 W 25TH ST
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340-2828
Practice Address - Country:US
Practice Address - Phone:209-383-3090
Practice Address - Fax:209-383-3091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-28
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Single Specialty