EVERGREEN SPINE AND PAIN CENTERS NPI 1760159198

NPI Information

  • NPI: 1760159198
  • Provider Name: EVERGREEN SPINE AND PAIN CENTERS
  • Classification: Pain Medicine - 208VP0014X
  • Specialization: Interventional Pain Medicine
  • Entity Type: Organization
  • CLIA Number: 05D1021518
  • Address: 3762 TIBBETTS ST
    RIVERSIDE, CA
    ZIP 92506
  • Phone: (949) 414-7246

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NPI Details

EVERGREEN SPINE AND PAIN CENTERS is an interventional pain medicine pain medicine in Riverside, CA. The provider is interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. EVERGREEN SPINE AND PAIN CENTERS NPI is 1760159198. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

3762 TIBBETTS ST
RIVERSIDE, CA
ZIP 92506-605
Phone: (949) 414-7246

The provider's authorized official is Yi Cai Isaac Tong .
The authorized official title is Ceo and has the following contact phone number (917) 745-6888.

The CLIA number assigned to this NPI record is 05D1021518 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/24/2021 and was last updated on 8/30/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207L00000XAnesthesiologyNo
2207LP2900XAnesthesiologyPain MedicineNo
3208VP0014XPain MedicineInterventional Pain MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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