Organization
APPLIED MEDICAL TECHNOLOGIES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AJAY GUPTA M.D. (CHIEF EXECUTIVE OFFICER)
(562) 412-6259
Entity
Organization
Contact information
Practice address
11859 COMPTON AVE, LOS ANGELES, CA 90059-2958
(323) 563-1140
(323) 357-3701
Mailing address
12804 HERITAGE PL, CERRITOS, CA 90703-6084
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
C50579
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0104210
—
CA
Enumeration date
06/30/2006
Last updated
12/20/2007
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