Premier Pain Management, Inc.

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

Legal business name

PREMIER PAIN MANAGEMENT, INC.

Practice address

11650 Riverside Dr
2ND Floor
North Hollywood, CA 91602-1093

Phone

(818) 753-1520

Fax

(818) 755-1870

NPI assigned

Oct 1, 2014

Last updated

Oct 1, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Benjamin Broukhim, M.D.

Title

Medical Director

Phone

(818) 753-1520

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1412121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412121600000",
    "number": "1962805242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11650 RIVERSIDE DR",
            "address_2": "2ND FLOOR",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916021093",
            "telephone_number": "818-753-1520",
            "fax_number": "818-755-1870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11650 RIVERSIDE DR",
            "address_2": "2ND FLOOR",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916021093",
            "telephone_number": "818-753-1520",
            "fax_number": "818-755-1870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PAIN MANAGEMENT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-01",
        "last_updated": "2014-10-01",
        "status": "A",
        "authorized_official_last_name": "BROUKHIM",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "818-753-1520",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pain Clinic/Center in North Hollywood, CA
• Providers in North Hollywood, 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 Oct 1, 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.