WEST COAST RENAL MEDICAL GROUP, INC (NPI# 1740637875) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740637875 |
| Entity Type | Organization |
| Organization Name | WEST COAST RENAL MEDICAL GROUP, INC |
| Practice Address |
2925 Sycamore Dr Suite 160 Simi Valley CA 93065-1207 |
| Mailing Address |
13990 Bear Fence Ct Moorpark CA 93021-5022 |
| Practice Telephone | 8055840177 |
| Practice Fax Number | 8055841179 |
| Mailing Telephone | 8187182301 |
| Mailing Fax Number | 8187182311 |
| Enumeration Date | 2016-05-18 |
| Last Update Date | 2017-12-19 |
| Authorized Official Name | DR. JIESHI YAN (PRESIDENT) |
| Authorized Official Telephone | 8187182301 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
Allopathic & Osteopathic Physicians |
| Street Address |
2925 SYCAMORE DR SUITE 160 |
| City | SIMI VALLEY |
| State | CA |
| Zip Code | 93065-1207 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144225269 | Simi Dermatologic Medical Center, Inc | Dermatology | 2925 Sycamore Dr, Ste 203, Simi Valley, CA 93065-1208 | 2005-06-15 |
| 1700121563 | Jill Lynn Collier | Registered Nurse | 2925 Sycamore Dr, Simi Valley, CA 93065-1207 | 2012-12-05 |
| 1457624124 | Atul Aggarwal Md A Medical Corp | Internal Medicine | 2925 Sycamore Dr, Suite 302b, Simi Valley, CA 93065-1207 | 2012-02-10 |
| 1326316449 | Anthony John Hoyle | Pharmacist | 2925 Sycamore Dr, Simi Valley, CA 93065-1207 | 2011-12-03 |
| 1255641437 | Susan D Organ | Physical Therapist | 2925 Sycamore Dr, Suite 202, Simi Valley, CA 93065-1207 | 2010-10-20 |
| 1710294665 | Forough Parsa Md A Medical Corporation | Internal Medicine | 2925 Sycamore Dr, Suite 300, Simi Valley, CA 93065-1207 | 2010-09-13 |
| 1578752986 | Gene M Broth Md Inc | Urology | 2925 Sycamore Dr, Suite 201, Simi Valley, CA 93065-1207 | 2007-10-22 |
| 1134313182 | Jerold T. Litoff, M.d. A Professional Corp. | Orthopaedic Surgery | 2925 Sycamore Dr, Suite 202, Simi Valley, CA 93065-1207 | 2007-09-04 |
| 1629297189 | Lisa N. Oki, Md A Medical Corporation | Dermatology | 2925 Sycamore Dr, Suite 101, Simi Valley, CA 93065-1207 | 2007-04-24 |
| 1477638468 | Donald I Kuzyk Dpm Inc | Podiatrist | 2925 Sycamore Dr, Suite 109, Simi Valley, CA 93065-1207 | 2006-10-26 |
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| 1528682499 | Nicole G. Nalbandian | Dentist | First Street Dental Group and Orthodontics, 1197 E Los Angeles Ave Ste E, Simi Valley, CA 93065 | 2020-06-05 |
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| 1487181301 | Renee Brooks | Marriage & Family Therapist | Ventura County Behavioral Health, 1227 E. Los Angeles Ave., Simi Valley, CA 93065 | 2017-05-23 |
| 1225577208 | Amanda Blake | Dietitian, Registered | 2592 Victoria St, Simi Valley, CA 93065 | 2017-02-23 |
| 1245778364 | Tyler James Arauza | Behavior Technician | 2856 Thicket Pl., Simi Valley, CA 93065 | 2017-02-09 |
| 1992169007 | Sahar Yaftaly | Dentist | 2045 Royal Ave Ste 109, Simi Valley, CA 93065 | 2016-04-06 |
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| 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 |
|---|---|---|---|---|
| 1780683193 | Ushakant Thakkar | Internal Medicine | 2650 Jones Way, Suite 3, Simi Valley, CA 93065-1203 | 2005-07-18 |
| 1538584263 | Simicare Medical Group Inc | Internal Medicine | 1164 Swallow Ln, Simi Valley, CA 93065-3154 | 2014-03-05 |
| 1396744546 | Jie Shi Yan | Internal Medicine | 2925 Sycamore Dr, Suite 160, Simi Valley, CA 93065-1207 | 2005-07-19 |
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| City | SIMI VALLEY |
| Zip Code | 93065 |
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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.