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General NPI Number Information
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NPI Number | 1700814373
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Entity Type | Organization
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Legal Business Name | APPLIED MEDICAL TECHNOLOGIES INC.
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Dates
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Enumeration Date | 06/30/2006
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Last Update Date | 12/20/2007
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Provider Practice Location Address
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Address Line | 11859 COMPTON AVE
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City | LOS ANGELES
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State | CA
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Zip | 90059-2958
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Country | US
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Telephone | 323-563-1140
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Fax | 323-357-3701
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Provider Business Mailing Address
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Address Line | 12804 HERITAGE PL
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City | CERRITOS
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State | CA
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Zip | 90703-6084
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | DR. AJAY GUPTA
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Credential | M.D.
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Telephone | 562-412-6259
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | C50579
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License Number State | CA
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