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General NPI Number Information
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NPI Number | 1609887157
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Entity Type | Organization
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Legal Business Name | TEMPLE CITY DIALYSIS FACILITY, INC.
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9945 LOWER AZUSA RD
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City | TEMPLE CITY
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State | CA
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Zip | 91780-4041
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Country | US
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Telephone | 626-442-3400
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Fax | 626-442-4800
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Provider Business Mailing Address
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Address Line | 1335 CYPRESS STREET SUITE 207
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City | SAN DIMAS
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State | CA
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Zip | 91773-3537
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Country | US
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Telephone | 909-542-2900
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Fax | 909-592-6000
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BASHIR AHMAD
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Credential | M.D.
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Telephone | 909-542-2900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number |
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License Number State | CA
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