Interventional Spine Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

FNP40048 Issued in CA

Legal business name

INTERVENTIONAL SPINE CENTER, LLC

Practice address

24012 Calle de la Plata
Suite 130
Laguna Hills, CA 92653

Phone

(949) 588-7246

Fax

(877) 854-7581

NPI assigned

Oct 26, 2016

Organization subpart

No

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

Authorized official

Name

Jennifer Baldock

Title

Officer and Authorized Official

Phone

(615) 234-5954

Specialties & licenses 1

Addresses

Tax ID family

Interventional Spine Center LLC2 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.

• Interventional Spine Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Anaheim, CA
  • NPI 1730487083
  NPD tax ID

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

{
    "created_epoch": "1477440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678233600000",
    "number": "1508318411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5105",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926165105",
            "telephone_number": "949-836-7665",
            "fax_number": "877-854-7581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24012 CALLE DE LA PLATA",
            "address_2": "SUITE 130",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "92653",
            "telephone_number": "949-588-7246",
            "fax_number": "877-854-7581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERVENTIONAL SPINE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-26",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A",
        "authorized_official_last_name": "BALDOCK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OFFICER AND AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "615-234-5954"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "FNP40048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tabitha Indries
• Seana Inducil, BCBA
• Inland Psychiatric Medical Group, Inc
• Lance Inouye
• Insight Health Corp
• Interventional Spine Center, LLC
• Irwin I Rosenfeld MD a Professional Corporation
• Ishani Shah DDS, Inc
• Zach Ismirnioglou, BA
• Ivan W Ho DDS Inc

• Ambulatory Surgical Clinic/Center in Laguna Hills, CA
• Providers in Laguna Hills, 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 Mar 8, 2023; 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.