| Southern California Snf Specialist Services | |
|
18335 Valley Blvd La Puente CA 91744-5968 | |
| (626) 810-3330 | |
| (626) 964-0440 |
| Full Name | Southern California Snf Specialist Services |
|---|---|
| Speciality | Internal Medicine |
| Location | 18335 Valley Blvd, La Puente, California |
| Authorized Official Name and Position | Hiren C Shah (OWNER) |
| Authorized Official Contact | 6268103330 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern California Snf Specialist Services 18335 Valley Blvd La Puente CA 91744-5968 Ph: (626) 810-3330 | Southern California Snf Specialist Services 18335 Valley Blvd La Puente CA 91744-5968 Ph: (626) 810-3330 |
| NPI Number | 1770715104 |
|---|---|
| Provider Enumeration Date | 08/18/2009 |
| Last Update Date | 08/18/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770715104 | NPI | - | NPPES |
| FNP39178 | Other | CA | MEDICAL BOARD OF CA FICTITIOUS NAME PERMIT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A56166 (California) | Primary |
| 207RN0300X | Internal Medicine - Nephrology | A42703 (California) | Secondary |
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