MEDICARE: BIO-MEDICAL APPLICATIONS OF CALIFORNIA, INC.

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		CA

General Provider Information

NPI Number	:	1669839973
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BIO-MEDICAL APPLICATIONS OF CALIFORNIA, INC.

Provider Business Mailing Address
First Line	:	3575 E WHITTIER BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90023-1709
Country	:	US
Telephone Number	:	323-307-9826
Fax Number	:	323-307-9885

Provider Business Practice Location Address
First Line	:	3575 E WHITTIER BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90023-1709
Country	:	US
Telephone Number	:	323-307-9826
Fax Number	:	323-307-9885

Authorized Official
Title or Position	:	TREASURER
Name	:	MARK FAWCETT
Credential	:
Telephone Number	:	781-699-9000

Provider Enumeration Date	:	01/19/2016
Last Update Date	:	12/16/2016

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