EQUI-MED CORP (NPI# 1619110269) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619110269 |
| Entity Type | Organization |
| Organization Name | EQUI-MED CORP |
| Practice Address |
1252 N Sierra Bonita Ave Pasadena CA 91104-3147 |
| Practice Telephone | 8052174998 |
| Mailing Telephone | 8052174998 |
| Enumeration Date | 2009-04-13 |
| Last Update Date | 2009-04-13 |
| Authorized Official Name | BRIAN JOHN COSTELLO (PRESIDENT) |
| Authorized Official Telephone | 8052174998 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
A43746 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
1252 N SIERRA BONITA AVE |
| City | PASADENA |
| State | CA |
| Zip Code | 91104-3147 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093284382 | Jack Lee Johnson II | Counselor | 1680 North Fair Oaks, Pasadena, CA 91104 | 2018-11-16 |
| 1699257055 | Aqueelah Russell | Lactation Consultant, Non-RN | 855 N. Catalina Ave, Pasadena, CA 91104 | 2018-09-02 |
| 1053893529 | Jordann Ashley Stewart | Case Manager/Care Coordinator | 691 East Washington Blvd, Pasadena, CA 91104 | 2018-08-31 |
| 1942789706 | Elmer Caballero | Case Manager/Care Coordinator | 691 E Washington Blvd, Pasadena, CA 91104 | 2018-08-12 |
| 1649759648 | Orlando Javier Sava Jr. | Case Manager/Care Coordinator | 1395 E. Orange Grove Blvd, Pasadena, CA 91104 | 2018-08-09 |
| 1669923611 | Grandview Foundation, Inc. | Substance Abuse Rehabilitation Facility | 225 Grandview Street, Pasadena, CA 91104 | 2016-10-14 |
| 1255734166 | Linhua Wang-kim | Massage Therapist | 1028 N. Lake Ave., Suite 108c, Pasadena, CA 91104 | 2014-10-06 |
| 1477893782 | Med Tec Diagnostic Inc. | Clinic/Center | 1310 N. Mar Vista Unit 3, Pasadena, CA 91104 | 2013-02-22 |
| 1750631321 | Gordon Sheldall | Marriage & Family Therapist | 1495 N Lake Avenue, Pasadena, CA 91104 | 2012-09-11 |
| 1699024521 | Sherry Lynn Wait | Marriage & Family Therapist | 1495 N. Lake Ave., Pasadena, CA 91104 | 2012-09-06 |
| Find all providers in zip 91104 | ||||
| Taxonomy Code | 2081P2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Pain Medicine |
| A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. A subspecialty certificate was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Proposal under development. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275871436 | Hudson Medical Group | Physical Medicine & Rehabilitation | 530 S Lake Ave # 451, Pasadena, CA 91101-3515 | 2013-01-23 |
| 1114218658 | Triet Q Huynh Md Pa | Physical Medicine & Rehabilitation | 5150 Crenshaw Rd Ste B100, Pasadena, TX 77505-3095 | 2011-05-01 |
| 1518126176 | Jos Santz II | Physical Medicine & Rehabilitation | 2693 E. Washington Blvd, Pasadena, CA 91107 | 2008-06-08 |
| 1417974478 | Harout Raffi Balian | Physical Medicine & Rehabilitation | 333 N Hill Ave, Suite 101, Pasadena, CA 91106-1570 | 2006-07-16 |
| 1245615350 | Ryan Mattie | Physical Medicine & Rehabilitation | 1017 S Fair Oaks Ave, Pasadena, CA 91105 | 2015-07-30 |
| 1750673638 | Jared Myers | Physical Medicine & Rehabilitation | 2627 E Washington Blvd, Pasadena, CA 91107-1412 | 2011-05-10 |
| 1104001213 | Plb United, Pa | Physical Medicine & Rehabilitation | 923 Pasadena Fwy, Pasadena, TX 77506-1400 | 2008-01-08 |
| 1700067295 | Jaspreet Kaur Takhar | Physical Medicine & Rehabilitation | 393 E Walnut St, 3rd Floor - Phrs, Pasadena, CA 91188-0001 | 2007-11-26 |
| 1528196045 | Vibha Agrawal | Physical Medicine & Rehabilitation | 1017 S Fair Oaks Ave, Pasadena, CA 91105-2621 | 2007-02-28 |
| 1386719904 | Mark Douglas Bernhard | Physical Medicine & Rehabilitation | 1060 E Green St, #107, Pasadena, CA 91106-2413 | 2006-11-21 |
| Find all providers in PASADENA | ||||
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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.