Provider Demographics
NPI:1417442203
Name:COMPTON QUEST DIALYSISCENTER
Entity Type:Organization
Organization Name:COMPTON QUEST DIALYSISCENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MEI
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIH
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:626-318-0303
Mailing Address - Street 1:7403 HELLMAN AVE
Mailing Address - Street 2:
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-2213
Mailing Address - Country:US
Mailing Address - Phone:562-988-8866
Mailing Address - Fax:562-988-8822
Practice Address - Street 1:457 S LONG BEACH BLVD
Practice Address - Street 2:
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90221-3427
Practice Address - Country:US
Practice Address - Phone:626-318-0303
Practice Address - Fax:626-280-7887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-25
Last Update Date:2018-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment