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PAIN MANAGEMENT SPECIALISTS MEDICAL GROUP
NPI 1265435416
Specialist in San Luis Obispo, CA

Active since May 23, 2005CLIA 05D1087052 · Certificate of Compliance
10 SANTA ROSA ST, STE 201, SAN LUIS OBISPO, CA 93405(805) 782-8132(805) 597-8350 Get Directions Write a Review

NPPES record last updated: December 29, 2010. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Pain Management Specialists Medical Group NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PAIN MANAGEMENT SPECIALISTS MEDICAL GROUP (NPI 1265435416), doing business as Interventional Pain Management, is a healthcare organization registered as a specialist in San Luis Obispo, California and active in the NPI registry since May 2005. The organization holds a CLIA Certificate of Compliance certificate valid through March 8, 2027 and lists Inna Gribanova, Manager, as its authorized official.

NPPES Registry Identity

NPI1265435416
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NamePAIN MANAGEMENT SPECIALISTS MEDICAL GROUP
Location Address10 SANTA ROSA ST, STE 201San Luis Obispo, CA 93405-5825
Mailing AddressPo Box 4659San Luis Obispo, CA 93403-4659 · (805) 782-8132 · Fax (805) 597-8350
Phone(805) 782-8132
Fax(805) 597-8350
Organization SubpartNo
Authorized OfficialInna GribanovaManager · (805) 782-8132
Enumeration DateMay 23, 2005
Last NPPES UpdateDecember 29, 2010
✔ NPI 1265435416 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
10 SANTA ROSA ST, San Luis Obispo, CA 93405
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Other Names 1

Former Legal Business NameInterventional Pain Management

Other Identifiers 2

MedicaidGR0105740CA
Medicare PINW18564CA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 05D1087052

Pain Management Specialists · San Luis Obispo, CA
Active · expires Mar 8, 2027
CLIA Number05D1087052
Laboratory TypePhysician Office
Certificate Effective DateMarch 9, 2025
Certificate Expiration DateMarch 8, 2027
Laboratory DirectorBoris I. Pilch
Laboratory Phone(805) 544-7246
Laboratory LocationPain Management Specialists10 Santa Rosa, Ste 201, San Luis Obispo, CA 93405
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TIMOTHY KUANG M.D.
Physical Medicine & Rehabilitation (Pain Medicine)
10 SANTA ROSA ST, STE, 201
SAN LUIS OBISPO, CA 93405
San Luis Obispo County (805) 544-7246
DAVID SANFORD LEVY PA-C
Physician Assistant (Medical)
10 SANTA ROSA ST, STE. 201
SAN LUIS OBISPO, CA 93405
San Luis Obispo County (805) 544-7246
CHERYL K DELOS REYES FNP-C
Nurse Practitioner (Family)
10 SANTA ROSA ST
SAN LUIS OBISPO, CA 93405
San Luis Obispo County (805) 544-7246
VINCENT W SAGENDORF CRNA
Nurse Anesthetist, Certified Registered
10 SANTA ROSA ST, STE. 201
SAN LUIS OBISPO, CA 93405
San Luis Obispo County (805) 544-7246
JASHVANT GANGARAM PATEL M.D.
Specialist
10 SANTA ROSA ST, STE. 201
SAN LUIS OBISPO, CA 93405
San Luis Obispo County (805) 544-7246
MS. SUZANNE J. MCCURDY NP
Nurse Practitioner (Family)
10 SANTA ROSA ST, STE 201
SAN LUIS OBISPO, CA 93405
San Luis Obispo County (559) 930-2334
DR. BORIS PILCH M.D.
Specialist
10 SANTA ROSA ST, SUITE 201
SAN LUIS OBISPO, CA 93405
San Luis Obispo County (805) 782-8132
BERNARD PHILLIP JONES I CRNA
Nurse Anesthetist, Certified Registered
10 SANTA ROSA ST, STE. 201
SAN LUIS OBISPO, CA 93405
San Luis Obispo County (805) 544-7246

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pain Management Specialists Medical Group's NPI number?

The NPI number for Pain Management Specialists Medical Group is 1265435416. It was assigned to this organization in the NPPES registry on May 23, 2005. The provider was formerly known as Interventional Pain Management.

Where is Pain Management Specialists Medical Group located?

Pain Management Specialists Medical Group is located at 10 Santa Rosa St Ste 201, San Luis Obispo, CA 93405. The listed phone number is (805) 782-8132.

What is Pain Management Specialists Medical Group's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Does Pain Management Specialists Medical Group hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 05D1087052) is associated with this NPI, valid through March 8, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Pain Management Specialists Medical Group was last updated on December 29, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.