Pain and Rehabilitation Medical Group, a Medical Corporation

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

G55631 Issued in CA

Legal business name

PAIN AND REHABILITATION MEDICAL GROUP, A MEDICAL CORPORATION

Practice address

3655 Lomita Blvd Ste 206
Torrance, CA 90505-1930

Phone

(310) 791-4980

Fax

(310) 791-4989

NPI assigned

Sep 13, 2006

Organization subpart

No

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

Authorized official

Name

Fabian A Proano, MDNPI 1932219169

Title

President

Phone

(310) 791-4980

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Fabian A Proano, MD

  • Pain Medicine (Anesthesiology) Physician
  • Torrance, CA
  • NPI 1932219169
  Medicare reassignment Care Compare group Authorized official
• Katrina Marie Von Kriegenbergh, MD

  • Pain Medicine (Anesthesiology) Physician
  • Torrance, CA
  • NPI 1013270867
  Medicare reassignment Care Compare group
• Gary J. Chang, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Monterey, CA
  • NPI 1366411548
  NPD (past)
• Erica L. Fleischauer, MS, MPT

  • Physical Therapist
  • Torrance, CA
  • NPI 1124247176
  NPD (past)
• Harold J. Gottlieb, PHD

  • Psychologist
  • Torrance, CA
  • NPI 1144300344
  NPD (past)

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732147200000",
    "number": "1720183973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3655 LOMITA BLVD STE 206",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905051930",
            "telephone_number": "310-791-4980",
            "fax_number": "310-791-4989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3655 LOMITA BLVD STE 206",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905051930",
            "telephone_number": "310-791-4980",
            "fax_number": "310-791-4989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN AND REHABILITATION MEDICAL GROUP, A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A",
        "authorized_official_last_name": "PROANO",
        "authorized_official_first_name": "FABIAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-791-4980",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "G60934",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "G55631",
            "primary": true
        },
        {
            "code": "2084P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Pain Medicine",
            "state": "CA",
            "license": "PSY4695",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Torrance",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "3655 Lomita Blvd Ste 206",
            "city": "Torrance",
            "state": "CA",
            "country_code": "US",
            "postal_code": "905051930",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ludivina Luis Pagatpatan, D.D.S.
• Jeremy Pagdilao
• Curtis Edwin Page
• Miranda Lynn Page
• Alex Pai, MD
• Pain Relief Surgery Center of Torrance, LLC
• Allison Paine
• Olivia Painter
• Christopher Paiz, MD
• Lydia M Pak, D.D.S.

• Pain Medicine (Anesthesiology) Physician in Torrance, CA
• Providers in Torrance, CA by specialty
• Pain Medicine (Anesthesiology) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; 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.