Therapeutic Pain Management Medical Clinic

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

Legal business name

THERAPEUTIC PAIN MANAGEMENT MEDICAL CLINIC

Practice address

1335 Buenaventura Blvd
#100
Redding, CA 96001-0160

Phone

(530) 241-0410

Fax

(530) 241-0472

NPI assigned

May 16, 2007

Organization subpart

No

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

Authorized official

Name

Robert Hansen, M.D.NPI 1407821317

Title

Mang Partnr

Phone

5302462410410

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

Practitioners 2

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

• Robert M Hansen, MD

  • Pain Medicine (Anesthesiology) Physician
  • Redding, CA
  • NPI 1407821317
  NPD Authorized official
• Shishir A Dhruva, MD

  • Interventional Pain Medicine Physician
  • Redding, CA
  • NPI 1629045125
  NPD

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267574400000",
    "number": "1720295249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3116 W MARCH LN",
            "address_2": "STE 200",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952192369",
            "telephone_number": "209-473-6555",
            "fax_number": "209-473-6543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1335 BUENAVENTURA BLVD",
            "address_2": "#100",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960010160",
            "telephone_number": "530-241-0410",
            "fax_number": "530-241-0472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERAPEUTIC PAIN MANAGEMENT MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2010-03-03",
        "status": "A",
        "authorized_official_last_name": "HANSEN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "MANG PARTNR",
        "authorized_official_telephone_number": "5302462410410",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DE. DHRUVA'S MD LIC #",
            "identifier": "A043275",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR HANSEN MD LIC #",
            "identifier": "G047619",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR IRANPUR MD LIC #",
            "identifier": "A070414",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Therapy Station, Inc.

• Pain Medicine Physician in Redding, CA
• Providers in Redding, CA by specialty
• Pain Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2010; 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.