NPIMap

Organization Active NPI

Pacific Integrative Medical Center, Inc

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Santa Monica, CA
National Provider Identifier
1942616990
Registry record updated Jul 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X
License
A108751 Issued in CA
Legal business name
PACIFIC INTEGRATIVE MEDICAL CENTER, INC
Practice address
2400 Broadway
Suite 520
Santa Monica, CA 90404-3030
Phone
(310) 453-8393
Fax
(310) 453-8696
NPI assigned
Jul 10, 2014
Last updated
Jul 10, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2014

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

Authorized official

Name
Keelie Steffen
Title
Office Manager
Phone
(310) 453-8393

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Chiropractor 111NN0400X 28098 CA
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X A108751 CA Primary

Addresses

Primary practice location

2400 Broadway
Suite 520
Santa Monica, CA 90404-3030

Mailing address

2400 Broadway
Suite 520
Santa Monica, CA 90404-3030
Phone (310) 453-8393

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1404950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404950400000",
    "number": "1942616990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 BROADWAY",
            "address_2": "SUITE 520",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904043030",
            "telephone_number": "310-453-8393",
            "fax_number": "310-453-8696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 BROADWAY",
            "address_2": "SUITE 520",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904043030",
            "telephone_number": "310-453-8393",
            "fax_number": "310-453-8696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC INTEGRATIVE MEDICAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-10",
        "last_updated": "2014-07-10",
        "status": "A",
        "authorized_official_last_name": "STEFFEN",
        "authorized_official_first_name": "KEELIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "310-453-8393"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "CA",
            "license": "28098",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "CA",
            "license": "A108751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2014; 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.