Organization
COUNTRY MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BHARATI SHAH M.D. (PRESIDENT)
(909) 860-2610
Entity
Organization
Contact information
Practice address
23341 GOLDEN SPRINGS DR, SUITE #210, DIAMOND BAR, CA 91765-2058
(909) 860-2610
(909) 860-1192
Mailing address
23341 GOLDEN SPRINGS DR, SUITE #210, DIAMOND BAR, CA 91765-2058
(909) 860-2610
(909) 860-1192
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
A36684
CA
Other
Enumeration date
12/03/2013
Last updated
12/03/2013
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