Advanced Pain Management & Wellness, a Medical Corporation

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

Legal business name

ADVANCED PAIN MANAGEMENT & WELLNESS, A MEDICAL CORPORATION

Practice address

1930 Wilshire Blvd
804
Los Angeles, CA 90057-3605

Phone

(213) 413-0413

Fax

(213) 947-4075

NPI assigned

Apr 12, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Jose Hernandez, PA

Title

President

Phone

(213) 413-0413

Specialties & licenses 2

Addresses

Other names 1

• Jose Hernandez, PA-C Other name

Locations

Practitioners 1

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

• Daniel Shin, MD

  • Pain Medicine (Anesthesiology) Physician
  • Los Angeles, CA
  • NPI 1801090188
  NPD (past)

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

{
    "created_epoch": "1365724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425945600000",
    "number": "1871936450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 WILSHIRE BLVD",
            "address_2": "804",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900573605",
            "telephone_number": "213-413-0413",
            "fax_number": "213-947-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 WILSHIRE BLVD",
            "address_2": "804",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900573605",
            "telephone_number": "213-413-0413",
            "fax_number": "213-947-4075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED PAIN MANAGEMENT & WELLNESS, A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-12",
        "last_updated": "2015-03-10",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "JOSE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "213-413-0413",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G075155",
            "primary": false
        },
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jose Hernandez, PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Pain Clinic/Center in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Pain Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2015; 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.