NPIMap

Organization Active NPI

Regional Pain Treatment Center

  • Non-Pharmacy Dispensing Site
  • Fullerton, CA
National Provider Identifier
1710305644
Registry record updated Mar 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
G59013 Issued in CA
Legal business name
REGIONAL PAIN TREATMENT CENTER
Practice address
295 Imperial Hwy
Suite 100
Fullerton, CA 92835-1020
Phone
(858) 345-7260
NPI assigned
Mar 28, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2014

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

Authorized official

Name
Cris Marquez Canchola
Title
Management Consultant
Phone
(858) 345-7260

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X G59013 CA Primary

Addresses

Primary practice location

295 Imperial Hwy
Suite 100
Fullerton, CA 92835-1020

Mailing address

295 Imperial Hwy
Suite 100
Fullerton, CA 92835-1020
Phone (858) 345-7260

National Provider Directory

National Provider Directory
Tax ID family
Regional Pain Treatment2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1395964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395964800000",
    "number": "1710305644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 IMPERIAL HWY",
            "address_2": "SUITE 100",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928351020",
            "telephone_number": "858-345-7260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 IMPERIAL HWY",
            "address_2": "SUITE 100",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928351020",
            "telephone_number": "858-345-7260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGIONAL PAIN TREATMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-28",
        "last_updated": "2014-03-28",
        "status": "A",
        "authorized_official_last_name": "CANCHOLA",
        "authorized_official_first_name": "CRIS",
        "authorized_official_middle_name": "MARQUEZ",
        "authorized_official_title_or_position": "MANAGEMENT CONSULTANT",
        "authorized_official_telephone_number": "858-345-7260"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "CA",
            "license": "G59013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2014; 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.