Prism Pain and Spine, Inc

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

PRISM PAIN AND SPINE, INC

Practice address

3838 San Dimas, Ste.
3838 San Dimas,Ste. B-231
Bakersfield, CA 93301

Phone

(661) 665-0505

Fax

(661) 665-7844

NPI assigned

Oct 16, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Daniel Krauchuk, D.O.

Title

President

Phone

(661) 665-0505

Specialties & licenses 1

Addresses

Other names 1

• Daniel Robert Krauchuk, D.O. Other name

Locations

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

{
    "created_epoch": "1539648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539648000000",
    "number": "1689140741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3838 SAN DIMAS, STE.B-231",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "93301",
            "telephone_number": "661-665-0505",
            "fax_number": "661-665-7844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3838 SAN DIMAS, STE.",
            "address_2": "3838 SAN DIMAS,STE. B-231",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "93301",
            "telephone_number": "661-665-0505",
            "fax_number": "661-665-7844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRISM PAIN AND SPINE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-16",
        "last_updated": "2018-10-16",
        "status": "A",
        "authorized_official_last_name": "KRAUCHUK",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "661-665-0505",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Daniel Robert Krauchuk, D.O.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Physical Medicine & Rehabilitation Physician in Bakersfield, CA
• Providers in Bakersfield, CA by specialty
• Physical Medicine & Rehabilitation Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2018; 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.