Southern California Pain and Spine, Inc.

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

G64292 Issued in CA

Legal business name

SOUTHERN CALIFORNIA PAIN AND SPINE, INC.

Practice address

1180 N Indian Canyon Dr
Ste W200
Palm Springs, CA 92262-4800

Phone

(408) 370-9080

NPI assigned

Nov 8, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Aiden M Clarke, M.D.

Title

Owner

Phone

(619) 564-7463

Specialties & licenses 1

Addresses

Practitioners 1

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

• Aidan M Clarke, MD

  • Pain Medicine (Anesthesiology) Physician
  • San Diego, CA
  • NPI 1215941158

  Interventional Pain Medicine

  NPD (past)

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

{
    "created_epoch": "1320710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331251200000",
    "number": "1154608909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 W MONTECITO WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921031227",
            "telephone_number": "619-564-7463",
            "fax_number": "619-564-7463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 N INDIAN CANYON DR",
            "address_2": "STE W200",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922624800",
            "telephone_number": "408-370-9080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CALIFORNIA PAIN AND SPINE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-08",
        "last_updated": "2012-03-09",
        "status": "A",
        "authorized_official_last_name": "CLARKE",
        "authorized_official_first_name": "AIDEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "619-564-7463",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "CA",
            "license": "G64292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael George Sotak, LCSW
• Jose Sotelo
• Arianne Janelle Soto, RN
• Lucia Alejandra Soto
• Patricia Sotolongo, DO
• SP and ML Enterprises Inc
• Specialized Psychology Solutions
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• Amanda A. Speed, BS,BM
• Jimmie Speed

• Interventional Pain Medicine Physician in Palm Springs, CA
• Providers in Palm Springs, 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 Mar 9, 2012; 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.