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General NPI Number Information
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NPI Number | 1417226648
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Entity Type | Organization
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Legal Business Name | KATTASH MEDICAL CORPORATION
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Dates
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Enumeration Date | 12/16/2011
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Last Update Date | 12/16/2011
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Provider Practice Location Address
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Address Line | 8710 MONROE CT SUITE 250
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-4883
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Country | US
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Telephone | 909-987-9100
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Fax | 909-987-9113
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Provider Business Mailing Address
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Address Line | 8710 MONROE CT SUITE 250
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-4883
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Country | US
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Telephone | 909-987-9100
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Fax | 909-987-9113
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. ANA ARRIAGA
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Credential |
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Telephone | 909-987-9100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | A88104
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License Number State | CA
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