Organization Name: | ARSALAN POURTEYMOUR MD INC |
NPI Number: | 1134434111 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ARSALAN POURTEYMOUR (M.D.) |
Mailing Address: | 345 N Riverside Ave Rialto |
State: | CA US |
Postal Code: | 923765925 |
Phone Number: | 9098758651 |
Fax Number: | 9098758709 |
NPI Enumeration Date: | 08/13/2010 |
NPI Last Update Date: | 03/07/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QH0100X |
License Number: | A52564 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Health Service |
Taxonomy Definition: |