PACIFIC NEPHROLOGY MEDICAL GROUP (NPI# 1922013515) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922013515 |
| Entity Type | Organization |
| Organization Name | PACIFIC NEPHROLOGY MEDICAL GROUP |
| Practice Address |
323 N Prairie Ave # 334 Inglewood CA 90301-4502 |
| Practice Telephone | 3106748600 |
| Practice Fax Number | 3106719883 |
| Mailing Telephone | 3106748600 |
| Mailing Fax Number | 3106719883 |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2009-09-21 |
| Authorized Official Name | DR. MICHAEL DYLAN HEALY (PARTNER) |
| Authorized Official Telephone | 3106748600 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0000360 | 05 |
| Street Address |
323 N PRAIRIE AVE # 334 |
| City | INGLEWOOD |
| State | CA |
| Zip Code | 90301-4502 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780703983 | Yep H. Wong, M.d. Inc | Specialist | 323 N Prairie Ave # 334, Inglewood, CA 90301-4502 | 2007-03-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548897945 | Genevieve V. Angel | Registered Nurse | 555 East Hardy Street, Director of Cm Sw, Centinela Hospital Medical Center, Inglewood, CA 90301 | 2020-03-25 |
| 1992338552 | Ralph Kevin Roque | Licensed Practical Nurse | 614 W Manchester Blvd, Inglewood, Ca 90301, 104, Inglewood, CA 90301 | 2020-02-21 |
| 1043841562 | Evelyn Jones | Social Worker | 555 E. Hardy Street, Inglewood, Ca, CA 90301 | 2020-02-03 |
| 1447896444 | Coral Dabarera Edelson | Dietitian, Registered | 110 North La Brea Ave, Inglewood, CA 90301 | 2019-11-25 |
| 1821642125 | Jennifer Robert Umoh | Student in an Organized Health Care Education/Training Program | 412 E Florence Avenue, Inglewood, CA 90301 | 2019-07-25 |
| 1821567751 | Esther Voltaire | Behavior Technician | 619 E Arbor Vitae St, Inglewood, CA 90301 | 2018-11-21 |
| 1902372832 | Pool Medical Supply Inc | Durable Medical Equipment & Medical Supplies | 323 North Prairie Ave, Suite 200, Ingelwood, CA 90301 | 2018-10-18 |
| 1174003594 | Xelnt Healthcare Inc. | Clinic/Center | 501 E Hardy St Ste 425, Inglewood, CA 90301 | 2018-08-15 |
| 1710409321 | Rae Shelston Mcintosh | Licensed Vocational Nurse | 1007 Myrth Ave, Inglewood, CA 90301 | 2017-07-14 |
| 1477093789 | Lewis E Logan II | Counselor | 332 N. Prairie Ave., Suite 417, Inglewood, CA 90301 | 2017-03-06 |
| Find all providers in zip 90301 | ||||
| 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 |
|---|---|---|---|---|
| 1306123252 | Jabir Rahman Sharif, M.d., Inc. | Internal Medicine | 4632 W Century Blvd Ste A, Inglewood, CA 90304-1454 | 2011-11-07 |
| 1700944279 | Randall Whitaker Maxey | Internal Medicine | 447 N Prairie Ave, Inglewood, CA 90301-1413 | 2006-12-05 |
| 1467488809 | Zahra Tabassian Md Inc | Internal Medicine | 994 S La Brea Ave, Inglewood, CA 90301-3816 | 2006-06-25 |
| 1497736938 | Jabir Rahman Sharif | Internal Medicine | 4632 W Century Blvd, Ste A, Inglewood, CA 90304-1454 | 2005-11-10 |
| 1558364711 | Richard Lee Sires | Internal Medicine | 323 N Prairie Ave, Ste 334, Inglewood, CA 90301-4505 | 2005-05-23 |
| 1053545129 | Christopher Woehrstein | Internal Medicine | 323 N Prairie Ave, Suite #334, Inglewood, CA 90301-4502 | 2009-05-05 |
| 1134384407 | Marjan Chegounchi Md Inc | Internal Medicine | 501 E Hardy St, Ste 205, Inglewood, CA 90301-4054 | 2008-07-25 |
| 1215960968 | Olu Oredugba,m.d. A Professional Medical Corporation | Internal Medicine | 575 E Hardy St, Suite 104, Inglewood, CA 90301-4036 | 2006-07-08 |
| 1871526533 | Michele Freeman,m.d., Inc. | Internal Medicine | 575 E Hardy St, Suite 104, Inglewood, CA 90301-4036 | 2006-07-08 |
| 1871521716 | Zahra Tabassian | Internal Medicine | 994 S La Brea Ave, Inglewood, CA 90301-3816 | 2006-06-29 |
| Find all providers in INGLEWOOD | ||||
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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.