MEDICARE: OPEN ACCESS MEDICAL CARE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician	A88403	CA

General Provider Information

NPI Number	:	1306170709
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPEN ACCESS MEDICAL CARE INC

Provider Business Mailing Address
First Line	:	3760 ATLANTIC AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90807-3409
Country	:	US
Telephone Number	:	562-595-7467
Fax Number	:	562-402-2214

Provider Business Practice Location Address
First Line	:	3760 ATLANTIC AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90807-3409
Country	:	US
Telephone Number	:	562-595-7467
Fax Number	:	562-402-2214

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. RAJIV K. DHAMIJA
Credential	:	M.D.
Telephone Number	:	562-595-7467

Provider Enumeration Date	:	10/01/2009
Last Update Date	:	06/22/2020

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