Organization
SAN DIMAS DIALYSIS CENTER A MEDICAL CORPORATION
Active
Other names
SAN DIMAS DIALYSIS CENTER, INC.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOJTABA MOGHADAM M.D. (PRESIDENT)
(909) 542-2900
Entity
Organization
Contact information
Practice address
1335 W CYPRESS AVE, SUITE 102, SAN DIMAS, CA 91773-3537
(909) 542-2900
(909) 394-1800
Mailing address
1335 W CYPRESS AVE, SUITE 207, SAN DIMAS, CA 91773-3537
(909) 542-2777
(909) 394-1800
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
550000175
CA
Other
Enumeration date
07/11/2006
Last updated
06/27/2012
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