Active NPI
Applied Medical Technologies Inc.
- Nephrology Physician
- Los Angeles, CA
National Provider Identifier
1700814373
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- C50579
- Legal business name
- APPLIED MEDICAL TECHNOLOGIES INC.
- Practice address
- 11859 Compton Ave
Los Angeles, CA 90059-2958 - Phone
- (323) 563-1140
- Fax
- (323) 357-3701
- NPI assigned
- Jun 30, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Ajay Gupta, M.D.
- Title
- Chief Executive Officer
- Phone
- (562) 412-6259
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | C50579 | CA | Primary |
Addresses
Primary practice location
11859 Compton Ave
Los Angeles, CA 90059-2958
Mailing address
12804 Heritage PL
Cerritos, CA 90703-6084
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GR0104210 | Medicaid | CA |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Nephrology Physician
- South Gate, CA
- NPI 1295753655
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151625600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1198108800000",
"number": "1700814373",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12804 HERITAGE PL",
"city": "CERRITOS",
"state": "CA",
"postal_code": "907036084"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11859 COMPTON AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900592958",
"telephone_number": "323-563-1140",
"fax_number": "323-357-3701"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "APPLIED MEDICAL TECHNOLOGIES INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-30",
"last_updated": "2007-12-20",
"status": "A",
"authorized_official_last_name": "GUPTA",
"authorized_official_first_name": "AJAY",
"authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
"authorized_official_telephone_number": "562-412-6259",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Nephrology",
"state": "CA",
"license": "C50579",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0104210",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.