Organization Active NPI

Corona Pain Management Center

  • Ambulatory Surgical Clinic/Center
  • Corona, CA
National Provider Identifier
1760740674
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
CORONA PAIN MANAGEMENT CENTER
Practice address
1810 Fullerton Ave
Suite 103
Corona, CA 92881-3103
Phone
(951) 734-7246
NPI assigned
Apr 27, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Authorized official

Name
Khuram A Sial, M.D.NPI 1508825381
Title
President
Phone
(951) 734-7246

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

1810 Fullerton Ave
Suite 103
Corona, CA 92881-3103

Mailing address

31569 Canyon Estates Dr Ste 135
Lake Elsinore, CA 92532-0472
Phone (951) 734-7246

Other names 1

  • Corona Specialty Care Surgery Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1335484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710374400000",
    "number": "1760740674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31569 CANYON ESTATES DR STE 135",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925320472",
            "telephone_number": "951-734-7246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 FULLERTON AVE",
            "address_2": "SUITE 103",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928813103",
            "telephone_number": "951-734-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORONA PAIN MANAGEMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-27",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A",
        "authorized_official_last_name": "SIAL",
        "authorized_official_first_name": "KHURAM",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-734-7246",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Corona Specialty Care Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Corona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2024; 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.