Healthcare Provider Details
I. General information
NPI: 1245255124
Provider Name (Legal Business Name): ARTHRITIS MEDICAL CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/13/2006
Last Update Date: 07/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6180 BROCKTON AVE STE 204
RIVERSIDE CA
92506-2233
US
IV. Provider business mailing address
6180 BROCKTON AVE STE 204
RIVERSIDE CA
92506-2233
US
V. Phone/Fax
- Phone: 951-781-7700
- Fax: 951-781-0313
- Phone: 951-781-7700
- Fax: 951-781-0313
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
BABAK
ZAMIRI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 951-781-7700