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General NPI Number Information
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NPI Number | 1134434111
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Entity Type | Organization
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Legal Business Name | ARSALAN POURTEYMOUR MD INC
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Dates
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Enumeration Date | 08/13/2010
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Last Update Date | 03/07/2016
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Provider Practice Location Address
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Address Line | 345 N RIVERSIDE AVE
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City | RIALTO
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State | CA
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Zip | 92376-5925
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Country | US
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Telephone | 909-875-8651
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Fax | 909-875-8709
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Provider Business Mailing Address
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Address Line | 10696 BOULDER CANYON RD
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City | ALTA LOMA
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State | CA
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Zip | 91737-2476
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Country | US
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Telephone | 909-875-8651
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Fax | 909-875-8709
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Authorized Official
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Title or Position | M.D.
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Name | ARSALAN POURTEYMOUR
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Credential |
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Telephone | 909-820-2212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | A52564
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License Number State | CA
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