Chronic Pain Management Clinic a Medical Corporation

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

A43746 Issued in CA

Legal business name

CHRONIC PAIN MANAGEMENT CLINIC A MEDICAL CORPORATION

Practice address

210 S Grand Ave Ste 315
Glendora, CA 91741-4284

Phone

(626) 610-3776

Fax

(626) 771-3191

NPI assigned

Jun 2, 2010

Organization subpart

No

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

Authorized official

Name

Brian L Gwartz, MD

Title

President

Phone

(626) 610-3776

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1275436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294790400000",
    "number": "1871813899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 S GRAND AVE STE 315",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917414284",
            "telephone_number": "626-610-3776",
            "fax_number": "626-771-3191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 S GRAND AVE STE 315",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917414284",
            "telephone_number": "626-610-3776",
            "fax_number": "626-771-3191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRONIC PAIN MANAGEMENT CLINIC A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-02",
        "last_updated": "2011-01-12",
        "status": "A",
        "authorized_official_last_name": "GWARTZ",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-610-3776",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "A43746",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "EE716A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Yena Choi, DDS
• Elaine Nicole Chow, DDS, MS
• Divya Chowdary
• Christine Shehata, DDS, Inc
• Cristina G Christopher, PAC
• Howard Chudler, MFT
• Joy Jia I Chung, M.S.
• Laura Goss Cina, MFT
• Citrus Community College
• Citrus Valley Cardiology Medical Group Inc

• Pain Medicine (Anesthesiology) Physician in Glendora, CA
• Providers in Glendora, CA by specialty
• Pain Medicine (Anesthesiology) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2011; 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.