Organization Active NPI

Applied Medical Technologies Inc.

  • Nephrology Physician
  • Los Angeles, CA
National Provider Identifier
1700814373
Registry record updated Dec 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
C50579 Issued in CA
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

Updated by the provider on Dec 20, 2007

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)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 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

IdentifierTypeStateIssuer
GR0104210MedicaidCA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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.

Verify at the official NPI Registry.