Healthcare Provider Details

I. General information

NPI: 1912305004
Provider Name (Legal Business Name): TEMPLE MEDICAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2014
Last Update Date: 12/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1410 W ALONDRA BLVD
COMPTON CA
90220-3533
US

IV. Provider business mailing address

854 S SYCAMORE AVE
LOS ANGELES CA
90036-4910
US

V. Phone/Fax

Practice location:
  • Phone: 562-208-9950
  • Fax:
Mailing address:
  • Phone: 562-208-9950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA26101
License Number StateCA

VIII. Authorized Official

Name: DR. T.S.S RAJAN
Title or Position: PRESIDENT
Credential:
Phone: 562-208-9950