RENOLOGY MEDICAL GROUP (NPI# 1083705081) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083705081 |
| Entity Type | Organization |
| Organization Name | RENOLOGY MEDICAL GROUP |
| Practice Address |
1510 S Central Ave Suite 210 Glendale CA 91204-2500 |
| Practice Telephone | 8189562111 |
| Practice Fax Number | 8189562122 |
| Mailing Telephone | 8189562111 |
| Mailing Fax Number | 8189562122 |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. ANTOINETTE GRANILLO (OFFICE MANAGER) |
| Authorized Official Telephone | 8189562111 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
A24092 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00A240920 | 05 |
| Street Address |
1510 S CENTRAL AVE SUITE 210 |
| City | GLENDALE |
| State | CA |
| Zip Code | 91204-2500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124020136 | Richard W Suda | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1510 S Central Ave, Suite 530, Glendale, CA 91204-2500 | 2005-08-10 |
| 1912381294 | Kyrillos Medical Group,inc | Specialist | 1510 S Central Ave, Suite 250, Glendale, CA 91204-2500 | 2015-07-16 |
| 1942699236 | Major Medical Management, Inc. | Clinic/Center | 1510 S Central Ave, Ste 120, Glendale, CA 91204-2500 | 2015-01-09 |
| 1124449384 | Mardi H. Mihranian | Specialist | 1510 S Central Ave, Suite 100, Glendale, CA 91204-2500 | 2013-12-13 |
| 1922429182 | Susan L. Chobanian, M.d. | Specialist | 1510 S Central Ave, Suite 100, Glendale, CA 91204-2500 | 2013-12-13 |
| 1861834178 | Ivan Brando Teves Aguilera | Podiatrist | 1510 S Central Ave, Ste 120, Glendale, CA 91204-2576 | 2013-07-28 |
| 1205176690 | Global Research Management, Inc | Specialist | 1510 S Central Ave, Suite 300, Glendale, CA 91204-2500 | 2013-02-21 |
| 1013206945 | Yen Tun Wang | Dermatology | 1510 S Central Ave, Suite 470, Glendale, CA 91204-2500 | 2011-03-31 |
| 1902105059 | Amandeep Kaur Randhawa | Podiatrist | 1510 S Central Ave, Suite 120, Glendale, CA 91204-2500 | 2011-03-15 |
| 1952543886 | Nathan Malcolm Miller | Chiropractor | 1510 S Central Ave, Suite 120, Glendale, CA 91204-2500 | 2009-03-24 |
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| 1558997387 | Hope & Trust Trading LLC | Radiology | 318 W Colorado St #2, Glendale, CA 91204 | 2020-03-12 |
| 1972133387 | Yusuf Toliver | Counselor | 1027 S Central Ave, Suite 200, Glendale, CA 91204 | 2020-01-24 |
| 1538633136 | Pathology La Inc. | Clinical Medical Laboratory | 4634 San Fernando Rd., Same As Above, Glendale, CA 91204 | 2019-01-16 |
| 1295254050 | Glendale Back and Pain Center | Neurological Surgery | 710 S. Central Ave, Suite 240, Glendale, CA 91204 | 2017-09-13 |
| 1285163568 | Ez Trans, Inc. | Transportation Broker | 1626 S. Central Ave., Glendale, CA 91204 | 2017-06-08 |
| 1194254474 | Jenny Chung | Pharmacist | 3943 San Fernando Road, Glendale, CA 91204 | 2017-06-08 |
| 1396111886 | Fresenius Medical Care Glendale, LLC | Clinic/Center | 623 S Central Ave, Glendale, CA 91204 | 2015-08-19 |
| 1710302450 | New Age Foot and Ankle Podiatry PC | Podiatrist | 705 Ivy Street, Glendale, CA 91204 | 2014-03-04 |
| 1124454376 | Alber K. Karamanoukian Medical Clinic, Inc. | Clinic/Center | 810 S. Central Avenue, Suite 100, Glendale, CA 91204 | 2013-09-19 |
| 1548521156 | Glendale Plastic and Reconstructive Surgery Inc. | Plastic Surgery | 1500 S. Central Ave. #126, Glendale, CA 91204 | 2012-05-31 |
| Find all providers in zip 91204 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
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|---|---|---|---|---|
| 1073030532 | Akdhc Surgery Center, LLC | Internal Medicine | 6622 N 91st Avenue, Suite 100, Glendale, AZ 85305 | 2017-08-25 |
| 1194255885 | Akdhc,llc | Internal Medicine | 6622 N 91st Ave, Suite 200, Glendale, AZ 85305 | 2017-06-14 |
| 1275918211 | Akdhc, LLC | Internal Medicine | 18699 N 67th Ave Ste 280, Glendale, AZ 85308-7149 | 2015-07-20 |
| 1053708511 | Rishi Kora | Internal Medicine | 5650 N Green Bay Ave Ste 210, Glendale, WI 53209-4447 | 2015-04-22 |
| 1518156942 | Akdhc, LLC | Internal Medicine | 5750 W Thunderbird Rd Ste G790, Glendale, AZ 85306-4678 | 2007-10-22 |
| 1174716765 | Sarbani Bhaduri | Internal Medicine | 661 Woodbury Rd, Glendale, CA 91206-2649 | 2007-08-27 |
| 1265406516 | Kamal Amin | Internal Medicine | 5650 N Green Bay Ave, Suite 100, Glendale, WI 53209-4446 | 2006-02-14 |
| 1245204858 | Lisa Haller | Internal Medicine | 5650 N Green Bay Ave Ste 100, Glendale, WI 53209-4447 | 2006-02-13 |
| 1639156466 | Abdul R Abukurah | Internal Medicine | 1818 Verdugo Boulevard, Suite 303, Glendale, CA 91208 | 2005-12-22 |
| 1831170950 | Duc Cong Bui | Internal Medicine | 801 S Chevy Chase Dr Ste 101, Glendale, CA 91205-4437 | 2005-11-07 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.