Provider Demographics
NPI:1316001027
Name:QTC MEDICAL GROUP, INC
Entity Type:Organization
Organization Name:QTC MEDICAL GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMSHID
Authorized Official - Middle Name:
Authorized Official - Last Name:TAMIRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:800-260-1515
Mailing Address - Street 1:21700 COPLEY DRIVE
Mailing Address - Street 2:#200
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765
Mailing Address - Country:US
Mailing Address - Phone:800-260-1515
Mailing Address - Fax:909-610-2623
Practice Address - Street 1:21700 COPLEY DRIVE
Practice Address - Street 2:#200
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91765
Practice Address - Country:US
Practice Address - Phone:800-260-1515
Practice Address - Fax:909-610-2623
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization