Organization Active NPI

Pain Management Medical Center

  • Pain Medicine Physician
  • Long Beach, CA
National Provider Identifier
1932139821
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
Legal business name
PAIN MANAGEMENT MEDICAL CENTER
Practice address
3545 Long Beach Blvd
Suite 105
Long Beach, CA 90807-3941
Phone
(562) 595-0060
Fax
(562) 981-0916
NPI assigned
Jul 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Medhat Fouad Mikhael, M.D.
Title
President/Owner
Phone
(562) 595-0060

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0000X Primary

Addresses

Primary practice location

3545 Long Beach Blvd
Suite 105
Long Beach, CA 90807-3941

Mailing address

3545 Long Beach Blvd
Suite 105
Long Beach, CA 90807-3941
Phone (562) 595-0060

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ592332ZOtherCABLUE SHIELD

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1932139821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3545 LONG BEACH BLVD",
            "address_2": "SUITE 105",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908073941",
            "telephone_number": "562-595-0060",
            "fax_number": "562-981-0916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3545 LONG BEACH BLVD",
            "address_2": "SUITE 105",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908073941",
            "telephone_number": "562-595-0060",
            "fax_number": "562-981-0916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN MANAGEMENT MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MIKHAEL",
        "authorized_official_first_name": "MEDHAT",
        "authorized_official_middle_name": "FOUAD",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "562-595-0060",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ592332Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.