1972481059 NPI number — SEKIWALA PAIN MANAGEMENT P.C.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972481059 NPI number — SEKIWALA PAIN MANAGEMENT P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SEKIWALA PAIN MANAGEMENT P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1972481059
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/26/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3857 BIRCH STREET
Provider Second Line Business Mailing Address:
SUITE 3139
Provider Business Mailing Address City Name:
NEWPORT BEACH
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92660
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
714-234-7485
Provider Business Mailing Address Fax Number:
714-701-1078

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5000 BIRCH STREET
Provider Second Line Business Practice Location Address:
SUITE 3000
Provider Business Practice Location Address City Name:
NEWPORT BEACH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92660
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-234-7485
Provider Business Practice Location Address Fax Number:
714-701-1078
Provider Enumeration Date:
08/26/2025

Additional Information

Authorized Official

Authorized Official Last Name:
KULUBYA
Authorized Official First Name:
EDWIN
Authorized Official Middle Name:
SAMUEL
Authorized Official Title or Position:
PROVIDER
Authorized Official Telephone Number:
714-234-7485

Provider Taxonomy Codes

  • Taxonomy code: 208VP0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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