East Bay Pain Clinic Inc

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

License

A128252 Issued in CA

Legal business name

EAST BAY PAIN CLINIC INC

Practice address

7351 Brentwood Blvd Ste a
Brentwood, CA 94513-2058

Phone

(925) 516-5656

Fax

(925) 516-5943

NPI assigned

Sep 9, 2015

Organization subpart

No

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

Authorized official

Name

Dan Jardin

Title

Owner

Phone

(925) 516-5656

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1441756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441756800000",
    "number": "1417325317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7351 BRENTWOOD BLVD STE A",
            "city": "BRENTWOOD",
            "state": "CA",
            "postal_code": "945132058",
            "telephone_number": "925-516-5656",
            "fax_number": "925-516-5943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7351 BRENTWOOD BLVD STE A",
            "city": "BRENTWOOD",
            "state": "CA",
            "postal_code": "945132058",
            "telephone_number": "925-516-5656",
            "fax_number": "925-516-5943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST BAY PAIN CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-09",
        "last_updated": "2015-09-09",
        "status": "A",
        "authorized_official_last_name": "JARDIN",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "925-516-5656"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC25146",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "A128252",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "CA",
            "license": "A128252",
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "CA",
            "license": "A128252",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sasha Alyssa Duenas
• Alexandra I Duque Silva, M.D.
• Destiny Duran, MA
• Linda Cristal Nungaray Duran
• East Bay Medical Supply
• East Bay Pain Management Center, Inc
• East Contra Costa Fire Protection District
• Mercy Amarachi Echendu
• Gianni Cynai Edwards
• Malissa Edwards

• Pain Medicine Physician in Brentwood, CA
• Providers in Brentwood, CA by specialty
• Pain Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.