Equi-Med Corp

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

A43746 Issued in CA

Legal business name

EQUI-MED CORP

Practice address

1252 N Sierra Bonita Ave
Pasadena, CA 91104-3147

Phone

(805) 217-4998

NPI assigned

Apr 13, 2009

Organization subpart

No

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

Authorized official

Name

Brian John Costello

Title

President

Phone

(805) 217-4998

Specialties & licenses 1

Addresses

Tax ID family

Equi-Med Corp2 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.

• Vantage Toxicology Management

  • Clinical Medical Laboratory
  • Simi Valley, CA
  • NPI 1760805428
  NPD tax ID

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

{
    "created_epoch": "1239580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239580800000",
    "number": "1619110269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1252 N SIERRA BONITA AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911043147",
            "telephone_number": "805-217-4998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1252 N SIERRA BONITA AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911043147",
            "telephone_number": "805-217-4998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EQUI-MED CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-13",
        "last_updated": "2009-04-13",
        "status": "A",
        "authorized_official_last_name": "COSTELLO",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-217-4998"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "CA",
            "license": "A43746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ensieh Mazaheri DDS Inc
• Stephanie Denise Entin, RDN
• Staci Lynn Epps
• Aaron J Epstein, M.D.
• Natalie Epstein
• Ana Laura Equihua Tenorio
• Equip Psychological Corporation
• Dafna Erana Hernandez, MD
• Pamela G Erdman, MFT
• Miya D Erickson, MSW, PSY.D.

• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2009; 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.