MEDICARE: COMPTON QUEST DIALYSISCENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QE0700X	End-Stage Renal Disease (ESRD) Treatment Clinic/Center

General Provider Information

NPI Number	:	1417442203
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPTON QUEST DIALYSISCENTER

Provider Business Mailing Address
First Line	:	7403 HELLMAN AVE
Second Line	:
City	:	ROSEMEAD
State	:	CA
Zip	:	91770-2213
Country	:	US
Telephone Number	:	562-988-8866
Fax Number	:	562-988-8822

Provider Business Practice Location Address
First Line	:	457 S LONG BEACH BLVD
Second Line	:
City	:	COMPTON
State	:	CA
Zip	:	90221-3427
Country	:	US
Telephone Number	:	626-318-0303
Fax Number	:	626-280-7887

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MEI SHIH
Credential	:	RN
Telephone Number	:	626-318-0303

Provider Enumeration Date	:	06/25/2018
Last Update Date	:	06/25/2018

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Directions to “COMPTON QUEST DIALYSISCENTER ” Practice Location

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