Organization Active NPI

Rancho Cucamonga Orthopedic Pain Management, Inc.

  • Multi-Specialty Clinic/Center
  • Rancho Cucamonga, CA
National Provider Identifier
1750771077
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
RANCHO CUCAMONGA ORTHOPEDIC PAIN MANAGEMENT, INC.
Practice address
8599 Haven Ave Ste 104
Rancho Cucamonga, CA 91730-4849
Phone
(909) 980-0917
Fax
(888) 416-6865
NPI assigned
Jan 24, 2015
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Pejman E. Shirazy, M.D.NPI 1669470068
Title
President/Medical Director
Phone
(818) 789-3964

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X A76100 CA
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

8599 Haven Ave Ste 104
Rancho Cucamonga, CA 91730-4849

Mailing address

16952 Ventura Blvd
Encino, CA 91316-4197
Phone (818) 789-3964

National Provider Directory

National Provider Directory

Locations

8599 Haven Ave
Ste 104
Rancho Cucamonga, CA 91730
Phone (909) 980-0917

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": "1422057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1750771077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16952 VENTURA BLVD",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913164197",
            "telephone_number": "818-789-3964",
            "fax_number": "818-789-3967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8599 HAVEN AVE STE 104",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917304849",
            "telephone_number": "909-980-0917",
            "fax_number": "888-416-6865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANCHO CUCAMONGA ORTHOPEDIC PAIN MANAGEMENT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-24",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SHIRAZY",
        "authorized_official_first_name": "PEJMAN",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "818-789-3964",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "CA",
            "license": "A76100",
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.