NPIMap

Organization Active NPI

Axiom Pain Management Inc

  • Pain Medicine (Anesthesiology) Physician
  • San Bernardino, CA
National Provider Identifier
1649440991
Registry record updated Mar 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
20A8829 Issued in CA
Legal business name
AXIOM PAIN MANAGEMENT INC
Practice address
1800 Medical Center Dr
Suite 105
San Bernardino, CA 92411-1233
Phone
(909) 880-0536
NPI assigned
Mar 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2011

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

Authorized official

Name
Jay Avila, D.O.
Title
President
Phone
(951) 929-6260

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207LP2900X 20A8829 CA Primary

Addresses

Primary practice location

1800 Medical Center Dr
Suite 105
San Bernardino, CA 92411-1233

Mailing address

PO Box 788
Hemet, CA 92546-0788
Phone (951) 929-6260

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1204502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299110400000",
    "number": "1649440991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 788",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925460788",
            "telephone_number": "951-929-6260",
            "fax_number": "951-765-2855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 MEDICAL CENTER DR",
            "address_2": "SUITE 105",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924111233",
            "telephone_number": "909-880-0536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AXIOM PAIN MANAGEMENT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-03",
        "last_updated": "2011-03-03",
        "status": "A",
        "authorized_official_last_name": "AVILA",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-929-6260",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "20A8829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2011; 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.