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General NPI Number Information
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NPI Number | 1316001027
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Entity Type | Organization
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Legal Business Name | QTC MEDICAL GROUP, INC
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Dates
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Enumeration Date | 12/20/2006
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Last Update Date | 10/01/2010
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Provider Practice Location Address
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Address Line | 21700 COPLEY DRIVE #200
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City | DIAMOND BAR
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State | CA
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Zip | 91765
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Country | US
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Telephone | 800-260-1515
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Fax | 909-610-2623
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Provider Business Mailing Address
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Address Line | 21700 COPLEY DRIVE #200
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City | DIAMOND BAR
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State | CA
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Zip | 91765
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Country | US
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Telephone | 800-260-1515
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Fax | 909-610-2623
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. JAMSHID TAMIRY
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Credential | MD
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Telephone | 800-260-1515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number |
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License Number State |
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