Advanced Interventional Pain Center la

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

C53502 Issued in CA

Legal business name

ADVANCED INTERVENTIONAL PAIN CENTER LA

Practice address

11645 Wilshire Blvd
Suite 852
Los Angeles, CA 90025-6808

Phone

(310) 272-9630

NPI assigned

Mar 29, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Pattanam Srinivasan, M.D.NPI 1225084155

Title

Clinical Director

Phone

(424) 781-5414

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.

• Pattanam Dorai Srinivasan, M.D.

  • Anesthesiology Physician
  • Clearwater, FL
  • NPI 1225084155

  Multi-Specialty

  NPD (past) Authorized official

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

{
    "created_epoch": "1332979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332979200000",
    "number": "1174899686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11645 WILSHIRE BLVD",
            "address_2": "SUITE 852",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256808",
            "telephone_number": "310-272-9630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11645 WILSHIRE BLVD",
            "address_2": "SUITE 852",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256808",
            "telephone_number": "310-272-9630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED INTERVENTIONAL PAIN CENTER LA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-29",
        "last_updated": "2012-03-29",
        "status": "A",
        "authorized_official_last_name": "SRINIVASAN",
        "authorized_official_first_name": "PATTANAM",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "424-781-5414",
        "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": "C53502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Interventional Pain Medicine Physician in Los Angeles, CA
• Providers in Los Angeles, 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 29, 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.