Organization Active NPI

Pain Control Associates of San Diego, Inc.

  • Interventional Pain Medicine Physician
  • Chula Vista, CA
National Provider Identifier
1437349578
Registry record updated Aug 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
A 92149 Issued in CA
Legal business name
PAIN CONTROL ASSOCIATES OF SAN DIEGO, INC.
Practice address
2452 Fenton St
Suite 101
Chula Vista, CA 91914-4551
Phone
(619) 271-1683
Fax
(619) 651-7033
NPI assigned
Jul 25, 2007
Last updated
Aug 22, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2008

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

Authorized official

Name
Dr. Michael H Verdolin, MD
Title
Owner
Phone
(619) 271-1683

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0014X A 92149 CA Primary

Addresses

Primary practice location

2452 Fenton St
Suite 101
Chula Vista, CA 91914-4551

Mailing address

2452 Fenton St
Suite 101
Chula Vista, CA 91914-3599
Phone (619) 271-1683

National Provider Directory

National Provider Directory

Locations

2452 Fenton St
Ste 101
Chula Vista, CA 91914
Phone (619) 271-1683

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219363200000",
    "number": "1437349578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2452 FENTON ST",
            "address_2": "SUITE 101",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919143599",
            "telephone_number": "619-271-1683",
            "fax_number": "619-651-7033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2452 FENTON ST",
            "address_2": "SUITE 101",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919144551",
            "telephone_number": "619-271-1683",
            "fax_number": "619-651-7033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN CONTROL ASSOCIATES OF SAN DIEGO, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-25",
        "last_updated": "2008-08-22",
        "status": "A",
        "authorized_official_last_name": "VERDOLIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "619-271-1683",
        "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": "A 92149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2008; 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.