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General NPI Number Information
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NPI Number | 1952538852
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Entity Type | Organization
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Legal Business Name | 1CHINOMED INC
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Dates
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Enumeration Date | 06/17/2009
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Last Update Date | 06/25/2009
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Provider Practice Location Address
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Address Line | 12598 CENTRAL AVE SUITE 112
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City | CHINO
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State | CA
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Zip | 91710-3502
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Country | US
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Telephone | 909-342-8821
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Fax |
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Provider Business Mailing Address
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Address Line | 12188 CENTRAL AVE SUITE 618
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City | CHINO
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State | CA
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Zip | 91710-2420
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Country | US
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Telephone | 909-342-8821
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ARASH NADERSHAHI
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Credential | M.D.
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Telephone | 909-342-8821
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | C51418
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License Number State | CA
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