FMR Interventional Quality Pain Management, a Professional Corp

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

Legal business name

FMR INTERVENTIONAL QUALITY PAIN MANAGEMENT, A PROFESSIONAL CORP

Doing business as

FMR Interventional QPM
FMR Interventional Quality Pain Management

Practice address

20620 Leapwood Ave
Suite H
Carson, CA 90746

Phone

(310) 294-9027

Fax

(562) 453-3059

NPI assigned

Jul 6, 2018

Last updated

Jul 28, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

F. Marina Russman, MD

Title

Medical Director/Owner

Phone

(310) 294-9027

Specialties & licenses 3

Addresses

Other names 2

• FMR Interventional QPM Doing business as
• FMR Interventional Quality Pain Management Doing business as

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1530835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690502400000",
    "number": "1568958171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12415 NORWALK BLVD",
            "address_2": "UNIT 59600",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "90652",
            "telephone_number": "310-294-9027",
            "fax_number": "562-453-3059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20620 LEAPWOOD AVE",
            "address_2": "SUITE H",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "90746",
            "telephone_number": "310-294-9027",
            "fax_number": "562-453-3059"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1900 W Garvey Ave S Ste 223",
            "address_purpose": "LOCATION",
            "city": "West Covina",
            "state": "CA",
            "postal_code": "917902653",
            "country_code": "US",
            "telephone_number": "310-294-9027",
            "fax_number": "562-453-3059",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12115 Paramount Blvd",
            "address_purpose": "LOCATION",
            "city": "Downey",
            "state": "CA",
            "postal_code": "902422309",
            "country_code": "US",
            "telephone_number": "562-242-2070",
            "fax_number": "562-242-2072",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14925 Burbank Blvd",
            "address_purpose": "LOCATION",
            "city": "Sherman Oaks",
            "state": "CA",
            "postal_code": "914113610",
            "country_code": "US",
            "telephone_number": "310-294-9027",
            "fax_number": "562-453-3059",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FMR INTERVENTIONAL QUALITY PAIN MANAGEMENT, A PROFESSIONAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-06",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A",
        "authorized_official_last_name": "RUSSMAN",
        "authorized_official_first_name": "F.",
        "authorized_official_middle_name": "MARINA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR/OWNER",
        "authorized_official_telephone_number": "310-294-9027",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@iqpmspine.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "20620 Leapwood Ave Ste H",
            "city": "Carson",
            "state": "CA",
            "country_code": "US",
            "postal_code": "907463671",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "FMR Interventional QPM",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "FMR Interventional Quality Pain Management",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.