Organization
HIGH DESERT NEPHROLOGY MEDICAL ASSOCIATES, INC.
Active
Parent organization
HIGH DESERT NEPHROLOGY MEDICAL ASSOCIATES, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
HIGH DESERT NEPHROLOGY MEDICAL ASSOCIATES, INC.
Authorized official
JAY ERIAH SHANKAR M.D. (OWNER/MEDICAL DIRECTOR)
(760) 241-3306
Entity
Organization
Contact information
Practice address
655 S. 7TH AVE., BARSTOW, CA 92311-3001
(760) 256-3918
(760) 256-5217
Mailing address
12675 HESPERIA RD., VICTORVILLE, CA 92395-5878
(760) 241-3306
(760) 241-8063
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508196759
—
CA
Enumeration date
01/12/2010
Last updated
02/23/2011
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