Pain Diagnosis & Treatment, Inc. a Medical Clinic

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

A43746 Issued in CA

Legal business name

PAIN DIAGNOSIS & TREATMENT, INC. A MEDICAL CLINIC

Practice address

210 S Grand Ave
315
Glendora, CA 91741-4205

Phone

(626) 857-7400

Fax

(626) 857-7404

NPI assigned

Mar 19, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Brian Leslie Gwartz, M.D.

Title

President

Phone

(626) 857-7400

Specialties & licenses 2

Addresses

Other identifiers 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)…

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430784000000",
    "number": "1891819447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 S GRAND AVE",
            "address_2": "315",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917414205",
            "telephone_number": "626-857-7400",
            "fax_number": "626-857-7404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 S GRAND AVE",
            "address_2": "315",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917414205",
            "telephone_number": "626-857-7400",
            "fax_number": "626-857-7404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN DIAGNOSIS & TREATMENT, INC. A MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2015-05-05",
        "status": "A",
        "authorized_official_last_name": "GWARTZ",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "LESLIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-857-7400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "A43746",
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "A20970",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A437461",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pacific Clinics
• Pacific Clinics
• Elisa Padilla, MSW, LCSW
• Harry John Pages, D.D.S.
• Vicky Chia-Pei Pai, M.D.
• Maricel Pangan
• Kaye Pantayatiwong
• Edna Fabiola Parada
• Caroline Paredes, L.C.S.W.
• Sabrina Justine Parra

• 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 May 5, 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.