5 Star Pain Relief PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

5 STAR PAIN RELIEF PC

Practice address

44530 San Pablo Ave
Suite 204
Palm Desert, CA 92260-3596

Phone

(760) 340-1264

Fax

(760) 340-0382

NPI assigned

Apr 30, 2013

Organization subpart

No

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

Authorized official

Name

William Lee Hathaway, DC

Title

President

Phone

(760) 340-1264

Specialties & licenses 2

Addresses

Other names 1

• N/A Doing business as

Locations

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

{
    "created_epoch": "1367280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431561600000",
    "number": "1154766566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44530 SAN PABLO AVE",
            "address_2": "SUITE 204",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922603596",
            "telephone_number": "760-340-1264",
            "fax_number": "760-340-0982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44530 SAN PABLO AVE",
            "address_2": "SUITE 204",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922603596",
            "telephone_number": "760-340-1264",
            "fax_number": "760-340-0382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "5 STAR PAIN RELIEF PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-30",
        "last_updated": "2015-05-14",
        "status": "A",
        "authorized_official_last_name": "HATHAWAY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-340-1264",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "N/A",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Internal Medicine Physician in Palm Desert, CA
• Providers in Palm Desert, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2015; 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.