Healthcare Provider Details

I. General information

NPI: 1033490453
Provider Name (Legal Business Name): ARROYO NEPHROLOGY ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2011
Last Update Date: 08/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2750 E WASHINGTON BLVD # 270
PASADENA CA
91107-1448
US

IV. Provider business mailing address

2750 E WASHINGTON BLVD # 270
PASADENA CA
91107-1448
US

V. Phone/Fax

Practice location:
  • Phone: 626-794-7075
  • Fax: 626-794-7215
Mailing address:
  • Phone: 626-794-7075
  • Fax: 626-794-7215

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberA41453
License Number StateCA

VIII. Authorized Official

Name: DR. ASHOK SUNDER RAJ
Title or Position: PRESIDENT
Credential: M.D.
Phone: 626-794-7075