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Organization

JAMBOOR MEDICAL CORPORATION

Active
Other names
Desert Cities Dialysis
Organization subpart
No

Provider details

NPI number
Authorized official
JAY ERIAH SHANKAR M.D. (OWNER)
(760) 241-8063
Entity
Organization

Contact information

Practice address
12675 HESPERIA RD, VICTORVILLE, CA 92395-5878
(760) 241-8063
(760) 241-5037
Mailing address
12675 HESPERIA RD, VICTORVILLE, CA 92395-5878
(760) 241-8063
(760) 241-5037

Taxonomy

Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
240000431
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
240000431
STATE DHS LICENSE
CA
Enumeration date
08/05/2006
Last updated
04/27/2022
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