Center for Interventional Spine, a Medical Corporation
Organization Active NPI Pain Medicine (Physical Medicine & Rehabilitation) Physician · Davis, CA
NPI 1972843399 · NPPES record last updated Feb 21, 2013
Key facts
- NPI
- 1972843399
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X
- License
- A60900 (CA)
- Legal business name
- CENTER FOR INTERVENTIONAL SPINE, A MEDICAL CORPORATION
- Practice address
- 1970 Lake Blvd
Suite 1
Davis, CA 95616-5663 - Phone
- (916) 977-0741
- Fax
- (916) 977-0547
- NPI assigned
- Feb 21, 2013
- Organization subpart
- No
Authorized official
- Name
- Mr. Lawrence Reed Cate
- Title
- Administrator
- Phone
- (916) 473-7602
Corporate family (same tax ID) 1
Practitioners 8
-
Barak Mevorak, M.D.
-
Jason Packer, P.A.-C, D.C.
-
Tyrell Jonathan Simkins, D.O., PH.D.
-
Timothy Yoon, M.D.
-
Bo Chung, MD
-
James P Murphy, M.D.
National Provider Directory
- Tax ID family
- Center for Interventional Spine a Medical Corpora
Locations
1970 Lake Blvd
Ste 1
Davis, CA 95616
Phone (916) 977-0741
3461 Brookside Rd
Ste B
Stockton, CA 95219
1526 Plumas Ct
Ste 100
Yuba City, CA 95991
Phone (530) 749-3475
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pain Medicine (Physical Medicine & Rehabilitation) Physician |
2081P2900X | A60900 | CA | Yes |
Addresses
Primary practice location
1970 Lake Blvd
Suite 1
Davis, CA 95616-5663
Mailing address
1817 Professional Dr
Sacramento, CA 95825-2106
Phone (916) 977-0741
Other providers in Davis, CA
- Tara Nicole Catledge
- Sara Elizabeth Catterton
- Steven F Cavagnolo
- Kevin Cecil
- Center for Focused Change, Inc.
- Center for Speech Pathology, Inc. a Professional Corporation
- Cep America - California
- Cep America - Neurology PC
- Jenit Kaur Chadha
- Nancy Chadwick
All providers in Davis, CA · Pain Medicine (Physical Medicine & Rehabilitation) Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 21, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.