Interventional Pain Management

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

G84064 Issued in CA

Legal business name

INTERVENTIONAL PAIN MANAGEMENT

Practice address

16311 Ventura Blvd
#1280
Encino, CA 91436-2124

Phone

(760) 772-8357

Fax

(760) 772-8406

NPI assigned

Jan 31, 2007

Organization subpart

No

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

Authorized official

Name

Paul Rodricks, MD

Title

President

Phone

(818) 981-4482

Specialties & licenses 1

Addresses

Other names 1

• INTERVENTIONAL PAIN MANAGEMENT MEDICAL GROUP INC. Doing business as

Locations

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435536000000",
    "number": "1972640548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3129",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905103129",
            "telephone_number": "310-792-3914",
            "fax_number": "855-898-4055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16311 VENTURA BLVD",
            "address_2": "#1280",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362124",
            "telephone_number": "760-772-8357",
            "fax_number": "760-772-8406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERVENTIONAL PAIN MANAGEMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2015-06-29",
        "status": "A",
        "authorized_official_last_name": "RODRICKS",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-981-4482",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "G84064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "INTERVENTIONAL PAIN MANAGEMENT MEDICAL GROUP INC.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pain Medicine (Anesthesiology) Physician in Encino, CA
• Providers in Encino, 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 Jun 29, 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.