Organization Active NPI

State-of-the-Art Technologies Inc.

  • Pain Medicine (Anesthesiology) Physician
  • Hawthorne, CA
National Provider Identifier
1962524231
Registry record updated Mar 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
A48906 Issued in CA
Legal business name
STATE-OF-THE-ART TECHNOLOGIES INC.
Practice address
4019 W Rosecrans Ave
Hawthorne, CA 90250-7913
Phone
(310) 675-9121
NPI assigned
Apr 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2012

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

Authorized official

Name
Dr. Osemwota Omoigui, MDNPI 1497825467
Title
Medical Director
Phone
(310) 675-9121

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207LP2900X A48906 CA Primary

Addresses

Primary practice location

4019 W Rosecrans Ave
Hawthorne, CA 90250-7913

Mailing address

4019 W Rosecrans Ave
Hawthorne, CA 90250-7913
Phone (310) 675-9121

Other names 1

  • L.A. Pain Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20101027000676 CA Part B Supplier - Clinic/Group Practice 1456545110 Receives reassigned benefits from 1 practitioner
Practice locations: Hawthorne, CA
O20110203000120 CA DME Supplier - Physician - Anesthesiology 1456545110 Practice locations: Hawthorne, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0914957L a Pain Clinic4019 W Rosecrans Avenue, Hawthorne, CA 90250Provider-performed microscopyOct 31, 2027

National Provider Directory

National Provider Directory

Locations

4019 W Rosecrans Ave
Hawthorne, CA 90250
Phone (310) 675-9121

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331596800000",
    "number": "1962524231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4019 W ROSECRANS AVE",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902507913",
            "telephone_number": "310-675-9121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4019 W ROSECRANS AVE",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902507913",
            "telephone_number": "310-675-9121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE-OF-THE-ART TECHNOLOGIES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2012-03-13",
        "status": "A",
        "authorized_official_last_name": "OMOIGUI",
        "authorized_official_first_name": "OSEMWOTA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "310-675-9121",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "A48906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "L.A. Pain Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hawthorne, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.