Organization Active NPI

Ravi Panjabi Inc

Doing business as Advanced Pain Management & Rehab Medical Group, Inc.

  • Medical Physician Assistant
  • Castro Valley, CA
National Provider Identifier
1669553970
Registry record updated Feb 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA16390 Issued in CA
Legal business name
RAVI PANJABI INC
Doing business as
Advanced Pain Management & Rehab Medical Group, Inc.
Practice address
3160 Castro Valley Blvd Ste a
Castro Valley, CA 94546-5565
Phone
(510) 582-8555
Fax
(510) 581-8686
NPI assigned
Oct 17, 2006
Last updated
Feb 5, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2020

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

Authorized official

Name
Dr. Ravi S Panjabi, MDNPI 1225024219
Title
Owner
Phone
(510) 582-8555

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
Medical Physician Assistant 363AM0700X PA16390 CA Primary
Nurse Practitioner 363L00000X NPF10862 CA

Addresses

Primary practice location

3160 Castro Valley Blvd Ste a
Castro Valley, CA 94546-5565

Mailing address

19850 Lake Chabot Rd
Castro Valley, CA 94546-4002
Phone (510) 582-8555

Other names 1

  • Advanced Pain Management & Rehab Medical Group, Inc. Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041123001262 CA Part B Supplier - Clinic/Group Practice 4183689680 Receives reassigned benefits from 5 practitioners
Practice locations: Fremont, CA; Castro Valley, CA

National Provider Directory

National Provider Directory

Locations

20450 LK Chabot Rd Ste 2
Castro Valley, CA 94546

20450 LK Chabot Rd Ste 2
Castro Valley, CA 94546
Phone (510) 582-8555

3160 Castro Valley Blvd
Castro Valley, CA 94546
Phone (510) 582-8555

3160 Castro Valley Blvd
Ste A
Castro Valley, CA 94546
Phone (510) 582-8555

3155 Kearney St
Ste 138
Fremont, CA 94538
Phone (510) 582-8555

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580860800000",
    "number": "1669553970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19850 LAKE CHABOT RD",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945464002",
            "telephone_number": "510-582-8555",
            "fax_number": "510-581-8686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3160 CASTRO VALLEY BLVD STE A",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945465565",
            "telephone_number": "510-582-8555",
            "fax_number": "510-581-8686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAVI PANJABI INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A",
        "authorized_official_last_name": "PANJABI",
        "authorized_official_first_name": "RAVI",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "510-582-8555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA16390",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NPF10862",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Pain Management & Rehab Medical Group, Inc.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Advanced Pain Management & Rehab Medical Group, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Castro Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.