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PRIME PAIN MEDICINE INSTITUTE
NPI 1538227897
Anesthesiology - Addiction Medicine in Capitola, CA

Active since December 05, 2006CLIA 05D1094950 · Waiver
4140 JADE ST, SUITE 102, CAPITOLA, CA 95010(831) 464-7246(831) 576-2016 Get Directions Write a Review

NPPES record last updated: October 30, 2023. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Prime Pain Medicine Institute NPPES

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

PRIME PAIN MEDICINE INSTITUTE (NPI 1538227897) is a healthcare organization registered as an addiction medicine in Capitola, California and active in the NPI registry since December 2006. The organization holds a CLIA Waiver certificate valid through January 28, 2027 and lists Victor Li, Md, as its authorized official.

NPPES Registry Identity

NPI1538227897
Entity TypeOrganization
Primary Taxonomy207LA0401X
Legal Business NameVICTOR LI MD A PROFESSIONAL MEDICAL
Location Address4140 JADE ST, SUITE 102Capitola, CA 95010-3956
Mailing Address4140 Jade St, Suite 102Capitola, CA 95010-3956 · (831) 464-7246 · Fax (831) 576-2016
Phone(831) 464-7246
Fax(831) 576-2016
Organization SubpartNo
Authorized OfficialVictor LiMd · (831) 464-7246
Enumeration DateDecember 5, 2006
Last NPPES UpdateOctober 30, 2023
NPPES CertifiedOctober 30, 2023
✔ NPI 1538227897 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAnesthesiology · Addiction MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207LA0401X
License✔ Licensed in CA · A77617
Definition
An anesthesiologist who specializes in the diagnosis and treatment of addictions.
4140 JADE ST, Capitola, CA 95010
Open in Google Maps ↗

Other Names 1

Doing Business AsPrime Pain Medicine Institute

Other Identifiers 3

Other00A776170CA · Blue Shield
OtherA77617CA · Blue Cross
Medicaid00A776170CA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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 Waiver 05D1094950

Prime Pain Medicine Institute · Capitola, CA
Active · expires Jan 28, 2027
CLIA Number05D1094950
Laboratory TypePhysician Office
Certificate Effective DateJanuary 29, 2025
Certificate Expiration DateJanuary 28, 2027
Laboratory DirectorVictor Li
Laboratory Phone(831) 464-7246
Laboratory LocationPrime Pain Medicine Institute4140 Jade St Suite 102, Capitola, CA 95010
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 7

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

MR. RAYMOND A VILLAVERDE P.A.
Physician Assistant (Surgical)
4140 JADE ST, SUITE 100
CAPITOLA, CA 95010
Santa Cruz County (831) 475-4344
KARIN TANAKA
Physician Assistant
4140 JADE ST
CAPITOLA, CA 95010
Santa Cruz County (408) 836-2922
PETER MCLEAN REYNOLDS MD
Orthopaedic Surgery (Sports Medicine)
4140 JADE ST, SUITE 100
CAPITOLA, CA 95010
Santa Cruz County (831) 475-4024
JOHN E. GOCHANGCO PA-C
Physician Assistant (Surgical)
4140 JADE ST, SUITE 100
CAPITOLA, CA 95010
Santa Cruz County (831) 475-4024
ORTHONORCAL, INC.
Specialist
4140 JADE ST, STE 100
CAPITOLA, CA 95010
Santa Cruz County (831) 475-4024
DANNY JOHNSON
Acupuncturist
4140 JADE ST, SUITE 102
CAPITOLA, CA 95010
Santa Cruz County (831) 464-7246
ORTHONORCAL, INC
Orthopaedic Surgery
4140 JADE ST, SUITE 100
CAPITOLA, CA 95010
Santa Cruz County (831) 475-4024

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 Victor Li MD A Professional Medical's NPI number?

The NPI number for Victor Li MD A Professional Medical is 1538227897. It was assigned to this organization in the NPPES registry on December 5, 2006. The provider is doing business as Prime Pain Medicine Institute.

Where is Victor Li MD A Professional Medical located?

Victor Li MD A Professional Medical is located at 4140 Jade St Suite 102, Capitola, CA 95010. The listed phone number is (831) 464-7246.

What is Victor Li MD A Professional Medical's specialty?

The primary specialty registered for this NPI is Anesthesiology, specializing in Addiction Medicine, with taxonomy code 207LA0401X.

Does Victor Li MD A Professional Medical hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D1094950) is associated with this NPI, valid through January 28, 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 Victor Li MD A Professional Medical was last updated on October 30, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.