Pain Medicine Specialty Group Inc.

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

Legal business name

PAIN MEDICINE SPECIALTY GROUP INC.

Practice address

11160 Warner Ave
417
Fountain Valley, CA 92708-4008

Phone

(714) 424-9300

Fax

(714) 424-9324

NPI assigned

Feb 11, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Chiwai E Chan, D.O.NPI 1629051529

Title

President

Phone

(714) 424-9300

Specialties & licenses 1

Addresses

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 1

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

• Chiwai E Chan, D.O.

  • Interventional Pain Medicine Physician
  • Fountain Valley, CA
  • NPI 1629051529
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1171152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466121600000",
    "number": "1770624702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11160 WARNER AVE",
            "address_2": "417",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084008",
            "telephone_number": "714-424-9300",
            "fax_number": "714-424-9324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11160 WARNER AVE",
            "address_2": "417",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084008",
            "telephone_number": "714-424-9300",
            "fax_number": "714-424-9324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN MEDICINE SPECIALTY GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-11",
        "last_updated": "2016-06-17",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "CHIWAI",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-424-9300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pacific Sleep Medicine Services Inc
• Susana Maria Paez
• Elliot Page, RBT
• Kea Ja Pai, MD
• Pain Medicine Associates, Inc.
• Angel Palencia
• Cindy Pallares
• Palm Healthcare, Inc.
• Janet Pan, M.D.
• Eric Panahi, M.D.

• Pain Medicine Physician in Fountain Valley, CA
• Providers in Fountain Valley, 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 Jun 17, 2016; 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.