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General NPI Number Information
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NPI Number | 1437375953
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Entity Type | Organization
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Legal Business Name | KAILASH DHAMIJA WALK IN MEDICAL CARE A MEDICAL CORPORATION
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 09/19/2014
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Provider Practice Location Address
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Address Line | 18326 PIONEER BLVD
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City | ARTESIA
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State | CA
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Zip | 90701-5533
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Country | US
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Telephone | 562-860-5599
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Fax | 562-402-2214
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Provider Business Mailing Address
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Address Line | 18326 PIONEER BLVD
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City | ARTESIA
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State | CA
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Zip | 90701-5533
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Country | US
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Telephone | 562-860-5599
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Fax | 562-402-2214
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. KAILASH R DHAMIJA
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Credential | RN
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Telephone | 562-860-5599
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | A42292
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License Number State | CA
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