SDPM MEDICAL GROUP, INCORPORATED (NPI# 1821640145) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1821640145 |
Entity Type | Organization |
Organization Name | SDPM MEDICAL GROUP, INCORPORATED |
Other Organization Name | SAN DIEGO PAIN MANAGEMENT |
Practice Address |
9850 Genesee Ave Ste 820 La Jolla CA 92037-1219 |
Mailing Address |
Po Box 221048 San Diego CA 92192-1048 |
Practice Telephone | 8584545442 |
Practice Fax Number | 8584314633 |
Mailing Telephone | 8583950309 |
Mailing Fax Number | 8584529027 |
Enumeration Date | 2019-07-16 |
Last Update Date | 2020-01-07 |
Authorized Official Name | ROBERT LEE WAGNER JR. (PRESIDENT) |
Authorized Official Telephone | 8584545442 |
Authorized Official Credential | MD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians |
Other Name | Type Code |
---|---|
San Diego Pain Management | Doing Business As Name - Organization |
Street Address |
9850 GENESEE AVE STE 820 |
City | LA JOLLA |
State | CA |
Zip Code | 92037-1219 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1720094055 | Robert Lee Wagner Jr. | Anesthesiology | 9850 Genesee Ave Ste 820, La Jolla, CA 92037-1219 | 2006-07-31 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982221768 | Equip Health Medical, PC | Clinic/Center | 2674 Costebelle Drive, Unit A, La Jolla, CA 92037 | 2020-06-29 |
1134745474 | Brenda Kay Wiederhold | Psychologist | Virtual Reality Medical Center, 9834 Genesee Avenue, Suite 427, La Jolla, CA 92037 | 2020-06-23 |
1316581598 | Kathleen M Blechertas | Physical Therapist | 9888 Genesee, Lj19, La Jolla, CA 92037 | 2019-10-31 |
1316592876 | Kevin Yanyan Li | Student in an Organized Health Care Education/Training Program | 9300 Campus Point Drive, Mc7400, La Jolla, CA 92037 | 2019-08-01 |
1407400542 | Juan J Salmeron | Dentist | Callejin Internacional 351 L2, Los Algodones, BAJA CALIFORNIA 92037 | 2019-07-26 |
1609428598 | Nicole Whitney Mark | Physician Assistant | 8103 Caminito Sonoma, La Jolla, CA 92037 | 2019-07-11 |
1700357936 | Cecelia Rose Greene/pendzich | Mastectomy Fitter | 7760 Fay Ave, Suite M., La Jolla, CA 92037 | 2018-12-16 |
1740765890 | Jeenal Ankit Gordhandas | Student in an Organized Health Care Education/Training Program | East Campus Office Building, Medical Center Dr, La Jolla, CA 92037 | 2018-09-25 |
1306325220 | Lisa Beth Perlov Marks | Marriage & Family Therapist | 7734 Hershel Avenue, Suite O, La Jolla, CA 92037 | 2018-08-10 |
1023596731 | Uc San Diego, Pathology Dept | Pathology | East Campus Office Building, Medical Center Dr, San Diego, CA 92037 | 2018-08-03 |
Find all providers in zip 92037 |
Taxonomy Code | 207LP2900X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Anesthesiology |
Specialization | Pain Medicine |
An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1720094055 | Robert Lee Wagner Jr. | Anesthesiology | 9850 Genesee Ave Ste 820, La Jolla, CA 92037-1219 | 2006-07-31 |
1891719233 | Gregory R Polston | Anesthesiology | 3600 Gilman Dr, Ucsd Department of Anesthesiology, La Jolla, CA 92093-0801 | 2006-07-27 |
1689018228 | Lars R. Newsome, M.d., Inc. | Anesthesiology | 4130 La Jolla Village Dr Ste 300, La Jolla, CA 92037-1481 | 2013-04-25 |
1669769980 | Joseph Shurman Md Integrative Pain Management Inc | Anesthesiology | 9834 Genesee Ave Ste 427, La Jolla, CA 92037-1264 | 2011-07-07 |
1205010030 | Imanuel Ruvin Lerman | Anesthesiology | 9300 Campus Point Dr, La Jolla, CA 92037-1300 | 2007-12-28 |
1972685949 | Wade Wong | Anesthesiology | 9300 Campus Point Dr, 7756, La Jolla, CA 92037 | 2006-10-19 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912512567 | Clinicas Del Valle, Inc | Anesthesiology | 120 W. Cole Blvd, Ste. B, Calexico, CA 92231 | 2020-09-10 |
1609489418 | Cyrus Dadachanji Md Inc. | Anesthesiology | 34762 Midland Ave, Murrieta, CA 92563-8419 | 2020-08-31 |
1962050401 | Sky Anesthesia Inc. | Anesthesiology | 4477 W 118th St Ste 501, Hawthorne, CA 90250-2260 | 2019-08-28 |
1932671856 | North County Pain Institute | Anesthesiology | 940 E Valley Pkwy Ste K, Escondido, CA 92025-3441 | 2018-12-18 |
1285101824 | 16th Street Anesthesia Services Corp | Anesthesiology | 2323 16th St Ste 507, Bakersfield, CA 93301-3454 | 2018-11-01 |
1033697305 | Heyer Anesthesia PC | Anesthesiology | 1120 W La Veta Ave Ste 330, Orange, CA 92868-4231 | 2018-07-30 |
1982190229 | Algos Inc., A Medical Corporation | Anesthesiology | 12840 Riverside Dr Ste 208, Valley Village, CA 91607-3343 | 2018-07-10 |
1093200610 | Kevin Dinh Trinh, Md Inc. | Anesthesiology | 100 Fieldwood, Irvine, CA 92618 | 2018-06-26 |
1033616644 | Howard Siegel Md Inc | Anesthesiology | 8112 Milliken Ave Ste 202, Rancho Cucamonga, CA 91730-7473 | 2018-04-10 |
1780198952 | Unified Physician Associates Inc | Anesthesiology | 3200 S Bristol St Ste B, Santa Ana, CA 92704-6711 | 2017-11-27 |
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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.