| Edinger Pain Management | |
|
10921 Wilshire Blvd Ste 1109 Los Angeles CA 90024-4005 | |
| (424) 273-4662 | |
| (310) 861-1358 |
| Full Name | Edinger Pain Management |
|---|---|
| Speciality | Pain Medicine |
| Location | 10921 Wilshire Blvd Ste 1109, Los Angeles, California |
| Authorized Official Name and Position | Lara Kristin Edinger (PRESIDENT) |
| Authorized Official Contact | 4242734662 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Edinger Pain Management 10921 Wilshire Blvd Ste 1109 Los Angeles CA 90024-4005 Ph: (424) 273-4662 | Edinger Pain Management 10921 Wilshire Blvd Ste 1109 Los Angeles CA 90024-4005 Ph: (424) 273-4662 |
| NPI Number | 1679020705 |
|---|---|
| Provider Enumeration Date | 09/07/2016 |
| Last Update Date | 11/28/2017 |
| Medicare PECOS PAC ID | 3274821269 |
|---|---|
| Medicare Enrollment ID | O20161209000813 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679020705 | NPI | - | NPPES |
| CB266766 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 20A14194 (California) | Secondary |
| 208VP0014X | Pain Medicine - Interventional Pain Medicine | 20A14194 (California) | Primary |
| Provider Name | Lara Kristin Edinger |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1053645887 PECOS PAC ID: 2567699788 Enrollment ID: I20160311000404 |
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