Organization Active NPI

Jesus H. Lao MD Inc

Doing business as Spectrum Pain and Spine Center

  • Pain Clinic/Center
  • San Diego, CA
National Provider Identifier
1679031611
Registry record updated Oct 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Clinic/CenterTaxonomy code 261QP3300X
Legal business name
JESUS H. LAO MD INC
Doing business as
Spectrum Pain and Spine Center
Practice address
6699 Alvarado Rd Ste 2304
San Diego, CA 92120-5241
Phone
(619) 255-8800
Fax
(619) 566-3827
NPI assigned
Mar 8, 2019
Last updated
Oct 7, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2020

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

Authorized official

Name
Jesus Lao, MDNPI 1275571010
Title
Medical Director
Phone
(619) 255-8800

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
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2081P2900X
Pain Clinic/Center 261QP3300X Primary

Addresses

Primary practice location

6699 Alvarado Rd Ste 2304
San Diego, CA 92120-5241

Mailing address

25431 Rue de Fleur
Escondido, CA 92026-8723
Phone (760) 484-4941

Other names 1

  • SPECTRUM PAIN AND SPINE CENTER Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200519001936 CA Part B Supplier - Clinic/Group Practice 4880025246 Receives reassigned benefits from 1 practitioner
Practice locations: San Diego, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2210409Jesus H. Lao, MD, Inc.6699 Alvarado Road Suite 2304, San Diego, CA 92120Certificate of waiverJan 20, 2027

National Provider Directory

National Provider Directory

Locations

6699 Alvarado Rd
Ste 2304
San Diego, CA 92120
Phone (619) 255-8800

Practitioners & affiliated clinicians

Practitioners 1

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": "1552003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602028800000",
    "number": "1679031611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25431 RUE DE FLEUR",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920268723",
            "telephone_number": "760-484-4941",
            "fax_number": "619-255-8083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6699 ALVARADO RD STE 2304",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921205241",
            "telephone_number": "619-255-8800",
            "fax_number": "619-566-3827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESUS H. LAO MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-08",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A",
        "authorized_official_last_name": "LAO",
        "authorized_official_first_name": "JESUS",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "619-255-8800",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SPECTRUM PAIN AND SPINE CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.