Organization Active NPI

Sanjoy Banerjee MD Inc

Doing business as Pacific Pain Care Consultants

  • Pain Medicine (Anesthesiology) Physician
  • Corona, CA
National Provider Identifier
1619287364
Registry record updated Jul 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
A90939 Issued in CA
Legal business name
SANJOY BANERJEE MD INC
Doing business as
Pacific Pain Care Consultants
Practice address
2097 Compton Ave
Ste 102
Corona, CA 92881-7282
Phone
(951) 735-7246
Fax
(951) 268-9516
NPI assigned
Oct 15, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2014

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

Authorized official

Name
Sanjoy Banerjee, MDNPI 1295773422
Title
Corporate Owner
Phone
(951) 735-7246

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207L00000X A90939 CA
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207LP2900X A90939 CA Primary

Addresses

Primary practice location

2097 Compton Ave
Ste 102
Corona, CA 92881-7282

Mailing address

2097 Compton Ave
Ste 102
Corona, CA 92881-7282
Phone (951) 735-7246

Other identifiers 2

IdentifierTypeStateIssuer
1295773422OtherINDIVIDUAL NPI
1619287365MedicaidCA

Other names 1

  • PACIFIC PAIN CARE CONSULTANTS Doing business as

National Provider Directory

National Provider Directory

Locations

1561 E Ontario Ave
Ste 103A
Corona, CA 92881
Phone (951) 688-5437

36243 Inland Valley Dr
Ste 20
Wildomar, CA 92595
Phone (909) 304-7103

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1287100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404172800000",
    "number": "1619287364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2097 COMPTON AVE",
            "address_2": "STE 102",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928817282",
            "telephone_number": "951-735-7246",
            "fax_number": "951-268-9516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2097 COMPTON AVE",
            "address_2": "STE 102",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928817282",
            "telephone_number": "951-735-7246",
            "fax_number": "951-268-9516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANJOY BANERJEE MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-15",
        "last_updated": "2014-07-01",
        "status": "A",
        "authorized_official_last_name": "BANERJEE",
        "authorized_official_first_name": "SANJOY",
        "authorized_official_title_or_position": "CORPORATE OWNER",
        "authorized_official_telephone_number": "951-735-7246",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A90939",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "A90939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1295773422",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1619287365",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PACIFIC PAIN CARE CONSULTANTS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Corona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2014; 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.