JAMBOOR MEDICAL CORPORATION NPI 1457362261

NPI Information

NPI: 1457362261
Provider Name: JAMBOOR MEDICAL CORPORATION

Doing Business As: DESERT CITIES DIALYSIS OF BARSTOW

Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

CLIA Number: 05D2071711

Address:
655 S 7TH AVE
BARSTOW, CA
ZIP 92311
Phone: (760) 256-3918
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JAMBOOR MEDICAL CORPORATION is an end-stage renal disease (esrd) treatment clinic center in Barstow, CA. JAMBOOR MEDICAL CORPORATION NPI is 1457362261. The provider is registered as an organization entity type.
The provider Is Doing Business As Desert Cities Dialysis Of Barstow.

The provider's business location address is:

655 S 7TH AVE
BARSTOW, CA
ZIP 92311-001
Phone: (760) 256-3918

The provider's authorized official is Jay Eriah Shankar .
The authorized official title is Ceo/medical Director and has the following contact phone number (760) 256-3918.

The CLIA number assigned to this NPI record is 05D2071711 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/10/2006 and was last updated on 4/27/2022.

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
1	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment	240000702	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	CA STATE LICENSE	OTHER	CALIFORNIA	240000702

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: 5/5/2024

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