Organization
JAMBOOR MEDICAL CORPORATION
Active
Other names
Desert Cities Dialysis of Barstow
Organization subpart
No
Provider details
NPI number
Authorized official
JAY ERIAH SHANKAR M.D. (CEO/MEDICAL DIRECTOR)
(760) 256-3918
Entity
Organization
Contact information
Practice address
655 S 7TH AVE, BARSTOW, CA 92311-3001
(760) 256-3918
Mailing address
655 S 7TH AVE, BARSTOW, CA 92311-3001
(760) 256-3918
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
240000702
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CA STATE LICENSE
240000702
CA
Enumeration date
08/10/2006
Last updated
04/27/2022
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