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Organization
HIGH DESERT NEPHROLOGY MEDICAL ASSOCIATES, INC.
Active
Organization
HIGH DESERT NEPHROLOGY MEDICAL ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAY ERIAH SHANKAR MD (CEO)
(760) 241-3306
Entity
Organization
Contact information
Practice address
12675 HESPERIA RD, VICTORVILLE, CA 92395-5878
(760) 241-3306
(760) 241-5037
Mailing address
12675 HESPERIA RD, VICTORVILLE, CA 92395-5878
(760) 241-3306
(760) 241-5037
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407865652
—
CA
Enumeration date
08/05/2006
Last updated
09/08/2010
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