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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