COMPREHENSIVE PAIN ASC, LLC (NPI# 1124406632) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124406632 |
| Entity Type | Organization |
| Organization Name | COMPREHENSIVE PAIN ASC, LLC |
| Practice Address |
16466 Bernardo Center Dr Suite 177 San Diego CA 92128-2508 |
| Mailing Address |
Po Box 501724 San Diego CA 92150-1724 |
| Practice Telephone | 8584537700 |
| Mailing Telephone | 8584537700 |
| Mailing Fax Number | 8587981225 |
| Enumeration Date | 2015-05-16 |
| Last Update Date | 2015-05-16 |
| Authorized Official Name | DR. CHRISTOPHER JG CHISHOLM (PRESIDENT) |
| Authorized Official Telephone | 8584537700 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities |
| Street Address |
16466 BERNARDO CENTER DR SUITE 177 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92128-2508 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053318048 | Susan Vivien B Chadkewicz | Dentist | 16466 Bernardo Center Dr, Suite 150, San Diego, CA 92128-2508 | 2005-07-05 |
| 1356795157 | Pain Allevia Medical Corporation | Physical Medicine & Rehabilitation | 16466 Bernardo Center Dr, Suite 150, San Diego, CA 92128-2522 | 2016-04-18 |
| 1598923674 | Corene Janna Poelman | Dentist | 16466 Bernardo Center Dr, Suite 176, San Diego, CA 92128-2508 | 2008-05-27 |
| 1992901219 | Timothy Daniel Chong | Physical Medicine & Rehabilitation | 16466 Bernardo Center Dr, Suite 150, San Diego, CA 92128-2508 | 2007-06-24 |
| 1083823843 | Heidi Lou Kamrath | Dentist | 16466 Bernardo Center Dr, Suite 176, San Diego, CA 92128-2508 | 2007-05-21 |
| 1477690030 | Namita Dutta | Dentist | 16466 Bernardo Center Dr, Ste. 185, San Diego, CA 92128-2508 | 2007-01-31 |
| 1487769121 | Corene J. Poelman, D.d.s., M.s., Apc | Dentist | 16466 Bernardo Center Dr, Suite 176, San Diego, CA 92128-2508 | 2006-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518585371 | Alicia Ford | Behavior Technician | 1170 Bernardo Plaza Court, Suite 350, San Diego, CA 92128 | 2020-07-08 |
| 1164087573 | Madeleine White | Dietitian, Registered | 16685 W Bernardo Dr, Suite 121, San Diego, CA 92128 | 2019-05-01 |
| 1053807677 | Joele Ghosn | Speech-Language Pathologist | 11838 Bernardo Plaza Ct #110, San Diego, CA 92128 | 2018-07-06 |
| 1376034348 | Eddie Reginald Burston II | In Home Supportive Care | 12727 Camino Emparrado, San Diego, CA 92128 | 2018-05-24 |
| 1336659218 | Ryan Fong | Physician Assistant | 15004 Innovation Drive (s97), San Diego, CA 92128 | 2017-10-05 |
| 1508316191 | Araceli Flores | Behavioral Analyst | 15737 Innovation Dr, Suite 200, San Diego, CA 92128 | 2016-10-07 |
| 1003283961 | Katherine Dishner | Hearing Instrument Specialist | 16766 Bernardo Center Dr Ste 206, San Diego, CA 92128 | 2015-08-27 |
| 1205212586 | Mobilia Dmd Inc. | Point of Service | 12405 Rancho Bernardo Rd., San Diego, CA 92128 | 2015-08-10 |
| 1346623634 | Angela Christine Storck-petersen | Dietitian, Registered | 11768 Caminito Corriente, San Diego, CA 92128 | 2015-07-04 |
| 1134526874 | Breeana Rose Lancaster | Speech-Language Pathologist | 11838 Bernardo Plaza Ct. Suite 110, Kids Therapy Associates, San Diego, CA 92128 | 2014-11-24 |
| Find all providers in zip 92128 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275006173 | Balboa Surgical Institute, Inc. | Clinic/Center | 7625 Mesa College Drive, Suite 315a, San Diego, CA 92111-5343 | 2019-01-03 |
| 1598276404 | Balboa Nephrology Medical Group,inc. | Clinic/Center | 6402 El Cajon Blvd Ste 100, San Diego, CA 92115-2645 | 2017-10-18 |
| 1316462377 | Ucsd Surgical Center of San Diego, LLC | Clinic/Center | 4910 Directors Pl Ste 100, San Diego, CA 92121-3814 | 2017-08-10 |
| 1710325220 | Carmel Valley Surgical Center | Clinic/Center | 11943 El Camino Real, Suite 100, San Diego, CA 92130-2597 | 2013-06-06 |
| 1346515095 | Medical Acadamy of Hawaii and Anatomical Learning Orginization | Clinic/Center | 5286 Eastgate Mall, San Diego, CA 92121-2815 | 2012-03-14 |
| 1245534460 | The Hilinski Ambulatory Surgery Center | Clinic/Center | 3720 4th Avenue, San Diego, CA 92103 | 2011-01-03 |
| 1538463153 | La Jolla Surgery Center | Clinic/Center | 4510 Executive Dr Ste 200a, San Diego, CA 92121-3023 | 2010-12-23 |
| 1922324177 | Surgical Center of San Diego, LLC | Clinic/Center | 4910 Directors Place, Suite 100, San Diego, CA 92121-3814 | 2010-04-13 |
| 1194968677 | Professional Surgicenter, Inc | Clinic/Center | 4510 Executive Dr Ste 105a, San Diego, CA 92121-3022 | 2009-04-13 |
| 1578729539 | The Reservoir Physicans Surgery Center, LLC | Clinic/Center | 6716 Alvarado Rd, San Diego, CA 92120 | 2008-07-30 |
| Find all providers in SAN DIEGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.