Organization
PERITONEAL DIALYSIS CENTER OF AMERICA - SAN GABRIEL, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRADIP C.P. CHOWDHURY MD (OWNER)
(323) 371-4182
Entity
Organization
Contact information
Practice address
809 S ATLANTIC BLVD, SUITE 103, MONTEREY PARK, CA 91754-4756
(626) 576-8556
(626) 576-8557
Mailing address
809 S ATLANTIC BLVD, SUITE 103, MONTEREY PARK, CA 91754-4756
(626) 576-8556
(626) 576-8557
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093062796
—
CA
Enumeration date
08/13/2012
Last updated
08/21/2023
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