Organization Active NPI

Integrated Pain Treatment Center

  • Interventional Pain Medicine Physician
  • Stockton, CA
National Provider Identifier
1659764397
Registry record updated Mar 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
INTEGRATED PAIN TREATMENT CENTER
Practice address
4312 Feather River Drive
Suite C
Stockton, CA 95219
Phone
(209) 207-0555
NPI assigned
Mar 5, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2015

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

Authorized official

Name
Dr. Ravi Pankhaniya, MD
Title
President
Phone
(415) 506-7284

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X Primary

Addresses

Primary practice location

4312 Feather River Drive
Suite C
Stockton, CA 95219

Mailing address

1157 Scotland Dr
Cupertino, CA 95014-5061

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1425513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425513600000",
    "number": "1659764397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1157 SCOTLAND DR",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950145061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4312 FEATHER RIVER DRIVE",
            "address_2": "SUITE C",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "95219",
            "telephone_number": "209-207-0555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED PAIN TREATMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-05",
        "last_updated": "2015-03-05",
        "status": "A",
        "authorized_official_last_name": "PANKHANIYA",
        "authorized_official_first_name": "RAVI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "415-506-7284",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2015; 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.