Center for Interventional Spine, a Medical Corporation

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

Legal business name

CENTER FOR INTERVENTIONAL SPINE, A MEDICAL CORPORATION

Practice address

2424 Arden Way Ste 301
Sacramento, CA 95825-2464

Phone

(916) 977-0741

Fax

(916) 977-0547

NPI assigned

Apr 12, 2007

Organization subpart

No

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

Authorized official

Name

Carl Hyun-Geol Shin

Title

Medical Director

Phone

(916) 977-0741

Specialties & licenses 5

Addresses

Other identifiers 3

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680220800000",
    "number": "1760606537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2424 ARDEN WAY STE 301",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958252464",
            "telephone_number": "916-977-0741",
            "fax_number": "916-977-0547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 ARDEN WAY STE 301",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958252464",
            "telephone_number": "916-977-0741",
            "fax_number": "916-977-0547"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1817 Professional Drive",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958252164",
            "country_code": "US",
            "telephone_number": "916-977-0741",
            "fax_number": "916-977-0547",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CENTER FOR INTERVENTIONAL SPINE, A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A",
        "authorized_official_last_name": "SHIN",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "HYUN-GEOL",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "916-977-0741"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "CA",
            "license": "A60900",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "CA",
            "license": "A60900",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "CA",
            "license": "A60900",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARL SHIN UPIN",
            "identifier": "G64120",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARL SHIN NPI",
            "identifier": "1255473575",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "5628017",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gerry Cendana, D.D.S.
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• Center for Higher Purpose
• Center for Interventional Spine, a Medical Corporation
• Center for Oral Health
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• Central Anesthesia Service Exchange Medical Group, Inc.
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• Interventional Pain Medicine Physician in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Interventional Pain Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.