PACIFIC SOUTH BAY DIALYSIS, LLC (NPI# 1548231350) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548231350 |
| Entity Type | Organization |
| Organization Name | PACIFIC SOUTH BAY DIALYSIS, LLC |
| Other Organization Name | U.S. RENAL CARE PACIFIC GATEWAY DIALYSIS |
| Practice Address |
1149 W 190th St Ste 1004 Gardena CA 90248-4321 |
| Mailing Address |
Po Box 749160 Los Angeles CA 90074-9160 |
| Practice Telephone | 3109650830 |
| Practice Fax Number | 3109650839 |
| Mailing Telephone | 5624958075 |
| Mailing Fax Number | 5624958076 |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2014-11-14 |
| Authorized Official Name | THOMAS L. WEINBERG (AUTHORIZED OFFICIAL) |
| Authorized Official Telephone | 2147362700 |
| Is Organization Subpart | Y |
| Parent Organization Name | U.S. RENAL CARE, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
930000908 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | CDC02821G | 05 |
| Other Name | Type Code |
|---|---|
| U.S. Renal Care Pacific Gateway Dialysis | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619948825 | Pacific South Bay Dialysis, LLC | Clinic/Center | 3295 Skypark Dr, Torrance, CA 90505-5004 | 2006-01-27 |
| 1003887282 | Pacific South Bay Dialysis, LLC | Clinic/Center | 1830 Lomita Blvd, Lomita, CA 90717-1906 | 2006-01-27 |
| 1922079987 | Pacific South Bay Dialysis, LLC | Clinic/Center | 20911 Earl St, Ste 160, Torrance, CA 90503-4352 | 2006-01-30 |
| 1912978164 | Pacific South Bay Dialysis, LLC | Clinic/Center | 1045 W Redondo Beach Blvd, Ste 105, Gardena, CA 90247-4128 | 2006-01-27 |
| Street Address |
1149 W 190TH ST STE 1004 |
| City | GARDENA |
| State | CA |
| Zip Code | 90248-4321 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912473307 | Occupational Health Centers of California, A Medical Corporation | Clinic/Center | 1149 W 190th St, Gardena, CA 90248-4321 | 2018-10-23 |
| 1649746033 | American Current Care of California, A Medical Corporation | Clinic/Center | 1149 W 190th St, Gardena, CA 90248-4321 | 2018-10-23 |
| 1164900148 | Jason Andrada | Registered Nurse | 1149 W 190th St, Gardena, CA 90248-4321 | 2018-08-01 |
| 1013465087 | U.S. Healthworks Medical Group, PC | Preventive Medicine | 1149 W 190th St, Gardena, CA 90248-4321 | 2016-09-19 |
| 1861735813 | Marie Lord | Psychiatry & Neurology | 1149 W 190th St, Gardena, CA 90248-4321 | 2013-03-28 |
| 1033490321 | Jina Ko Yang | Registered Nurse | 1149 W 190th St, Gardena, CA 90248-4321 | 2011-08-31 |
| 1255542536 | Patrick L. Ignacio | Emergency Medicine | 1149 W 190th St, Gardena, CA 90248-4321 | 2007-05-25 |
| 1356499297 | Alvaro Prieto | Physician Assistant | 1149 W 190th St, Suite 2300, Gardena, CA 90248-4321 | 2007-01-08 |
| 1780638254 | West Los Angeles Vamc | Clinic/Center | 1149 W 190th St, First Floor, Gardena, CA 90248-4321 | 2006-05-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215537543 | Gereine Mae Condino Datan | Nurse Practitioner | 500 W 190 St, Gardena, CA 90248 | 2020-10-27 |
| 1154811297 | Patrick Lee | Technician/Technologist | 18203 S. Western Ave Ste. 102, Torrance, CA 90248 | 2018-05-15 |
| 1386152445 | Ariana Felicitas Nieves | Behavioral Analyst | 870 W 190th St Ste 400, Gardena, CA 90248 | 2018-01-11 |
| 1265949606 | Jessica Keller | Behavioral Analyst | 879 W 190th St Suite 400, Gardena, CA 90248 | 2018-01-08 |
| 1265941199 | Jaimee E Munson | Behavioral Analyst | 18726 S. Western Ave St, #408, Gardena, CA 90248 | 2017-09-22 |
| 1922467349 | Fred Jefferson Memorial Homes | Substance Abuse Rehabilitation Facility | 152 W. Walnut, Suite 150, Gardena, CA 90248 | 2016-02-12 |
| 1922427442 | Shana Reilly | Behavioral Analyst | 18726 S. Western Ave., Suite 408, Los Angeles, CA 90248 | 2014-04-11 |
| 1588002216 | Aacres Ca, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 19300 S. Hamilton Ave, Ste 130, Gardena, CA 90248 | 2013-06-04 |
| 1093057598 | Aids Health Foundation | Pharmacist | 19300 S. Hamilton Ave., Ste 170, Gardena, CA 90248 | 2013-03-22 |
| 1245576594 | Hye Mi Kim | Behavioral Analyst | 18726 S. Western Ave.,#408, Gardena, CA 90248 | 2012-12-13 |
| Find all providers in zip 90248 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710477914 | Springpond Dialysis LLC | Clinic/Center | 1201 W 155th St, Gardena, CA 90247-4096 | 2018-05-14 |
| 1962903690 | Usrc Pacific Gateway LLC | Clinic/Center | 1149 W 190th St Ste 1004, Gardena, CA 90248-4333 | 2018-02-27 |
| 1386145092 | Usrc Gardena, LLC | Clinic/Center | 1045 W Redondo Beach Blvd Ste 105, Gardena, CA 90247-4184 | 2018-02-27 |
| 1912978164 | Pacific South Bay Dialysis, LLC | Clinic/Center | 1045 W Redondo Beach Blvd, Ste 105, Gardena, CA 90247-4128 | 2006-01-27 |
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|---|---|---|---|---|
| 1306444765 | Kinter Dialysis, LLC | Clinic/Center | 1055 El Camino Real, Colma, CA 94014-3234 | 2020-10-16 |
| 1063010734 | Monad Dialysis, LLC | Clinic/Center | 5238 Manzanita Ave, Carmichael, CA 95608-0510 | 2020-10-14 |
| 1891305462 | Auberry's Home Hemo Dialysis | Clinic/Center | 8200 S Normandie Ave, Los Angeles, CA 90044-2336 | 2020-08-07 |
| 1376152645 | Navin Dialysis, LLC | Clinic/Center | 4314 E Jensen Ave, Fresno, CA 93706-9049 | 2020-07-23 |
| 1669080107 | Total Renal Care Inc | Clinic/Center | 4270 Rosewood Dr Ste E, Pleasanton, CA 94588-3065 | 2020-07-21 |
| 1659997112 | Arbela Dialysis LLC | Clinic/Center | 900 Huntington Dr Ste B, San Marino, CA 91108-1825 | 2020-06-22 |
| 1275158487 | Cudahy Peritoneal Dialysis Center | Clinic/Center | 4566 Florence Ave Ste 3, Cudahy, CA 90201-4346 | 2020-06-12 |
| 1659994903 | Bio Medical Applications of California Inc | Clinic/Center | 1287 N Hacienda Blvd, La Puente, CA 91744-1631 | 2020-05-21 |
| 1245853654 | Culbert Dialysis LLC | Clinic/Center | 4223 E Anaheim St, Long Beach, CA 90804-4202 | 2020-05-20 |
| 1790308179 | Palo Dialysis LLC | Clinic/Center | 10211 Long Beach Road, Lynwood, CA 90262-1508 | 2020-05-20 |
| Find all providers with the same taxonomy | ||||
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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.