University Spine and Pain Center Inc

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

A95636 Issued in CA

Legal business name

UNIVERSITY SPINE AND PAIN CENTER INC

Practice address

555 Pier Ave
Suite 1
Hermosa Beach, CA 90254-3839

Phone

(714) 254-5751

NPI assigned

Sep 27, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Bao Nguyen, MDNPI 1194913756

Title

President

Phone

(714) 254-5751

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Tax ID family

University Spine Pain Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• University Spine & Pain Center

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Hermosa Beach, CA
  • NPI 1922435411
  NPD tax ID

Locations

Practitioners 3

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

• Bao Thai Nguyen, MD

  • Physical Medicine & Rehabilitation Physician
  • Hermosa Beach, CA
  • NPI 1194913756
  Medicare reassignment Care Compare group NPD Authorized official
• Joseph Carl Peck, M.D.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Manhattan Beach, CA
  • NPI 1053368472
  Medicare reassignment Care Compare group NPD
• Matthew Ryan Robinson, D.O.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Hermosa Beach, CA
  • NPI 1427402288
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1380240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394409600000",
    "number": "1295162808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 PIER AVE",
            "address_2": "SUITE 1",
            "city": "HERMOSA BEACH",
            "state": "CA",
            "postal_code": "902543839",
            "telephone_number": "714-254-5751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 PIER AVE",
            "address_2": "SUITE 1",
            "city": "HERMOSA BEACH",
            "state": "CA",
            "postal_code": "902543839",
            "telephone_number": "714-254-5751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY SPINE AND PAIN CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-27",
        "last_updated": "2014-03-10",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "BAO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-254-5751",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "A95636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• TLC Pharmacy
• Emily Torchiana, MA, AMFT, APCC
• Torrance Health Association Inc
• Alanna Turner, MS
• University Spine & Pain Center
• Julie Rose Ursic
• Andres Valdez
• Sonia Vallejo
• Amy Shepardson Van Dusen, RN, NBC-HWC
• Marissa Velasco-Adania, AMFT

• Physical Medicine & Rehabilitation Physician in Hermosa Beach, CA
• Providers in Hermosa Beach, CA by specialty
• Physical Medicine & Rehabilitation Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.