Pain Diagnosis & Treatment Inc., a Medical Clinic

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

A43746 Issued in CA

Legal business name

PAIN DIAGNOSIS & TREATMENT INC., A MEDICAL CLINIC

Practice address

10630 Downey Ave
Suite 102
Downey, CA 90241-3463

Phone

(562) 861-5170

NPI assigned

Dec 6, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Terri Wickman

Title

Biller

Phone

(626) 857-7400

Specialties & licenses 2

Addresses

Other identifiers 1

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)…

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

{
    "created_epoch": "1196899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294790400000",
    "number": "1043493570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 S GRAND AVE",
            "address_2": "SUITE 315",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917414205",
            "telephone_number": "626-857-7400",
            "fax_number": "626-857-7404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10630 DOWNEY AVE",
            "address_2": "SUITE 102",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902413463",
            "telephone_number": "562-861-5170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN DIAGNOSIS & TREATMENT INC., A MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-06",
        "last_updated": "2011-01-12",
        "status": "A",
        "authorized_official_last_name": "WICKMAN",
        "authorized_official_first_name": "TERRI",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "626-857-7400",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "A43746",
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "A020970",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A437461",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pacific Vascular Access Care, Inc
• Maria Magdalena Padilla
• Rocio Carmen Padilla, P.T.A
• Yuliana Edith Padilla
• Jeannie Paik, PHARM.D.
• Mary Divine Grace Dinsay Painaga, FNP
• Kathleen Paisley, OTR
• Thomas Pak
• Emily Fay Palacio, FNP-BC
• Casey Ann Palin

• Pain Medicine (Anesthesiology) Physician in Downey, CA
• Providers in Downey, CA by specialty
• Pain Medicine (Anesthesiology) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.