Organization Active NPI

Elite Pain Management Inc.

  • Interventional Pain Medicine Physician
  • Santa Ana, CA
National Provider Identifier
1346449394
Registry record updated May 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
A85749 Issued in CA
Legal business name
ELITE PAIN MANAGEMENT INC.
Practice address
2010 E 1St St Ste 100
Santa Ana, CA 92705-4086
Phone
(714) 556-7246
Fax
(714) 556-7247
NPI assigned
Jul 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2012

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

Authorized official

Name
Dr. Marc B Cheng, MDNPI 1417018342
Title
President
Phone
(714) 556-7246

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0014X A85749 CA Primary

Addresses

Primary practice location

2010 E 1St St Ste 100
Santa Ana, CA 92705-4086

Mailing address

2010 E 1St St Ste 100
Santa Ana, CA 92705-4086
Phone (714) 556-7246

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081204000636 CA Part B Supplier - Clinic/Group Practice 6204922388 Receives reassigned benefits from 8 practitioners
Practice locations: Santa Ana, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D1102662Elite Pain Management Inc2010 E 1St St Ste 100, Santa Ana, CA 92705Certificate of waiverJul 21, 2027

National Provider Directory

National Provider Directory

Locations

3620 S Bristol St
Ste 205
Santa Ana, CA 92704
Phone (714) 556-7246

15462 Goldenwest St
Westminster, CA 92683

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)…

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335830400000",
    "number": "1346449394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 E 1ST ST STE 100",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927054086",
            "telephone_number": "714-556-7246",
            "fax_number": "714-556-7247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 E 1ST ST STE 100",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927054086",
            "telephone_number": "714-556-7246",
            "fax_number": "714-556-7247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE PAIN MANAGEMENT INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-11",
        "last_updated": "2012-05-01",
        "status": "A",
        "authorized_official_last_name": "CHENG",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-556-7246",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "CA",
            "license": "A85749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.