Southern California Pain Consultants Inc

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

G82005 Issued in CA

Legal business name

SOUTHERN CALIFORNIA PAIN CONSULTANTS INC

Practice address

4201 Torrance Blvd
Suite 590
Torrance, CA 90503-4536

Phone

(310) 540-9888

Fax

(310) 540-0444

NPI assigned

Sep 28, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kenneth Sterling Bradley, M.D., M.D.

Title

Ceo, President

Phone

(310) 540-9888

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kenneth Sterling Bradley, MD

  • Pain Medicine Physician
  • Torrance, CA
  • NPI 1558479352
  Medicare reassignment Care Compare group
• Rushton E Halbert III, PA

  • Physician Assistant
  • Harbor City, CA
  • NPI 1528269412
  Medicare reassignment Care Compare group
• Navneet K. Boddu, M.D.

  • Interventional Pain Medicine Physician
  • San Diego, CA
  • NPI 1811917396

  Anesthesiology

  Medicare reassignment NPD
• Keong Moon Joung, MD

  • Physical Medicine & Rehabilitation Physician
  • North Las Vegas, NV
  • NPI 1447456918

  CA

  Medicare reassignment NPD
• Kartik Ananth, MD

  • Pain Medicine (Psychiatry & Neurology) Physician
  • Torrance, CA
  • NPI 1821279423
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1348790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589328000000",
    "number": "1013268069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2129",
            "city": "PALOS VERDES PENINSULA",
            "state": "CA",
            "postal_code": "902748129",
            "telephone_number": "310-540-9888",
            "fax_number": "310-540-0444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 TORRANCE BLVD",
            "address_2": "SUITE 590",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905034536",
            "telephone_number": "310-540-9888",
            "fax_number": "310-540-0444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CALIFORNIA PAIN CONSULTANTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-28",
        "last_updated": "2020-05-13",
        "certification_date": "2020-05-13",
        "status": "A",
        "authorized_official_last_name": "BRADLEY, M.D.",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "STERLING",
        "authorized_official_title_or_position": "CEO, PRESIDENT",
        "authorized_official_telephone_number": "310-540-9888",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G82005",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A109016",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "CA",
            "license": "G82005",
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "CA",
            "license": "A109016",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sozo Health, Inc.
• Sozo Integrative Wellness

• Interventional Pain Medicine Physician in Torrance, CA
• Providers in Torrance, CA by specialty
• Interventional Pain Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.