Provider Demographics
NPI:1063740322
Name:KATTASH MEDICAL CORP
Entity type:Organization
Organization Name:KATTASH MEDICAL CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:HELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:YOU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-987-9100
Mailing Address - Street 1:8710 MONROE CT
Mailing Address - Street 2:SUITE 250
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-4883
Mailing Address - Country:US
Mailing Address - Phone:909-987-9100
Mailing Address - Fax:909-987-9113
Practice Address - Street 1:8710 MONROE CT
Practice Address - Street 2:SUITE 250
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-4883
Practice Address - Country:US
Practice Address - Phone:909-987-9100
Practice Address - Fax:909-987-9113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-25
Last Update Date:2009-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical