SOUTHLAND RENAL MEDICAL GROUP, INC (NPI# 1134252679) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134252679 |
| Entity Type | Organization |
| Organization Name | SOUTHLAND RENAL MEDICAL GROUP, INC |
| Practice Address |
18111 Brookhurst St Ste 6700 Fountain Valley CA 92708 |
| Mailing Address |
3300 E South St Ste 308 Lakewood CA 90805-4598 |
| Practice Telephone | 5626303111 |
| Practice Fax Number | 5626303107 |
| Mailing Telephone | 5626303111 |
| Mailing Fax Number | 5626303107 |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2018-08-15 |
| Authorized Official Name | CORA FISCHMAN (COO) |
| Authorized Official Telephone | 5626303111 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
A46344 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0093374 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851589600 | Southland Renal Medical Group, Inc | Internal Medicine | 1045 Atlantic Ave, Suite 902, Long Beach, CA 90813-3408 | 2007-10-05 |
| 1992838429 | Southland Renal Medical Group, Inc | Internal Medicine | 11480 Brookshire Ave, Suite 110, Downey, CA 90241 | 2007-03-13 |
| 1447383971 | Southland Renal Medical Group, Inc | Internal Medicine | 2865 Atlantic Ave, Suite 101, Long Beach, CA 90806-1740 | 2007-03-13 |
| Street Address |
18111 BROOKHURST ST STE 6700 |
| City | FOUNTAIN VALLEY |
| State | CA |
| Zip Code | 92708 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932716222 | Changing Directions Psychological Corporation | Psychologist | 17280 Newhope Street, Suite 4, Fountain Valley, CA 92708 | 2020-09-30 |
| 1124632757 | Neck & Back Pain Specialists, A Balta Chiropractic Corporation | Chiropractor | 10231 Slater Ave. #113, Fountain Valley, CA 92708 | 2020-09-01 |
| 1295205425 | Alexander Nee Dds Inc | Dentist | 337 S Rancho Santa Fe Rd, San Marcos, CA 92708 | 2018-11-30 |
| 1093293052 | Claudia Raquel Santos | Physical Therapist | 18384 Brookhurst Street, Fountain Valley, CA 92708 | 2018-08-01 |
| 1659864338 | Orange County Respiratory Physicians Corp | Internal Medicine | 18111 Brookhurst St Ste 4600, Fountain Valley, CA 92708 | 2018-06-07 |
| 1992297881 | Ereny Abdelmalak Metry | Pharmacist | 9064 Daffodil Ave, Fountain Valley, CA 92708 | 2018-06-06 |
| 1144746348 | Goose Pharma, LLC | Pharmacy | 18049 Magnolia Street, Fountain Valley, CA 92708 | 2017-08-18 |
| 1932622347 | Mayra Alejandra Guerra | Social Worker | 18350 Mt Langley St, Suite 200, Fountain Valley, CA 92708 | 2017-07-18 |
| 1942722129 | Graph Surgery Inc | Plastic Surgery | 10760 Warner Ave, Ste 201, Fountain Valley, CA 92708 | 2017-07-10 |
| 1871022277 | Cathy A Castagna-petersen | Counselor | 10529 Slater Avenue, Fountain Valley, CA 92708 | 2017-06-08 |
| Find all providers in zip 92708 | ||||
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528560802 | Victoria P. Chung, Md Inc | Internal Medicine | 11100 Warner Ave Ste 118, Fountain Valley, CA 92708-7500 | 2018-03-02 |
| 1407964976 | Tarun Marwaha | Internal Medicine | 11180 Warner Ave Ste 463, Fountain Valley, CA 92708-7505 | 2006-08-26 |
| 1730146937 | Sandeep Singh Dang | Internal Medicine | 11100 Warner Ave Ste 218, Fountain Valley, CA 92708-7511 | 2006-05-01 |
| 1316932270 | Essam A Mostafa | Internal Medicine | 11100 Warner Ave Ste 158, Fountain Valley, CA 92708-7510 | 2005-09-16 |
| 1366070583 | Nephrology Independent Physicians Association Inc | Internal Medicine | 11180 Warner Ave Ste 463, Fountain Valley, CA 92708-7505 | 2020-04-01 |
| 1508492919 | Nephrology Independent Practice Association, Inc. | Internal Medicine | 11180 Warner Ave Ste 463, Fountain Valley, CA 92708-7505 | 2020-03-17 |
| 1548817836 | Premier Nephrology of Orange County Inc | Internal Medicine | 11100 Warner Ave Ste 158, Fountain Valley, CA 92708-7510 | 2019-08-21 |
| 1912352774 | Gaytri Manek Md Inc | Internal Medicine | 11180 Warner Ave, Ste 271, Fountain Valley, CA 92708-7501 | 2016-04-29 |
| 1053791095 | Platinum Medical Care | Internal Medicine | 11100 Warner Ave, Suite 218, Fountain Valley, CA 92708-7511 | 2015-06-04 |
| 1255677134 | Zavier Shawkat Ahmed | Internal Medicine | 11180 Warner Ave Ste 463, Fountain Valley, CA 92708-7505 | 2012-12-20 |
| Find all providers in FOUNTAIN VALLEY | ||||
| City | FOUNTAIN VALLEY |
| Zip Code | 92708 |
Please comment or provide details below to improve the information on SOUTHLAND RENAL MEDICAL GROUP, INC.
| 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.