California Pain Surgical Institute, Inc

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

CALIFORNIA PAIN SURGICAL INSTITUTE, INC

Practice address

1100 E Broadway Ste 301
Glendale, CA 91205-1380

Phone

(310) 971-4757

Fax

(855) 795-4464

NPI assigned

Dec 17, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Yashar Ghomri, DONPI 1861717704

Title

Ceo and Director

Phone

(630) 889-2122

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, and the practitioner matching its NPPES authorized official.

• Yashar M Ghomri

  • Interventional Pain Medicine Physician
  • Glendale, CA
  • NPI 1861717704
  NPD Authorized official

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

{
    "created_epoch": "1608163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608163200000",
    "number": "1407442981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 E BROADWAY STE 301",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051380",
            "telephone_number": "310-971-4757",
            "fax_number": "855-795-4464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E BROADWAY STE 301",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051380",
            "telephone_number": "310-971-4757",
            "fax_number": "855-795-4464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA PAIN SURGICAL INSTITUTE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-17",
        "last_updated": "2020-12-17",
        "certification_date": "2020-12-17",
        "status": "A",
        "authorized_official_last_name": "GHOMRI",
        "authorized_official_first_name": "YASHAR",
        "authorized_official_title_or_position": "CEO AND DIRECTOR",
        "authorized_official_telephone_number": "630-889-2122",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in Glendale, CA
• Providers in Glendale, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2020; 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.