USRC PACIFIC GATEWAY LLC (NPI# 1962903690) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962903690 |
| Entity Type | Organization |
| Organization Name | USRC PACIFIC GATEWAY LLC |
| Other Organization Name | U.S. RENAL CARE PACIFIC GATEWAY DIALYSIS |
| Practice Address |
1149 W 190th St Ste 1004 Gardena CA 90248-4333 |
| Mailing Address |
Po Box 251549 Plano TX 75025-1500 |
| Practice Telephone | 3109650830 |
| Enumeration Date | 2018-02-27 |
| Last Update Date | 2018-02-27 |
| Authorized Official Name | THOMAS L WEINBERG (CHAIRMAN) |
| 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 |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| U.S. Renal Care Pacific Gateway Dialysis | Doing Business As Name - Organization |
| Street Address |
1149 W 190TH ST STE 1004 |
| City | GARDENA |
| State | CA |
| Zip Code | 90248-4333 |
| 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 |
| 1386145092 | Usrc Gardena, LLC | Clinic/Center | 1045 W Redondo Beach Blvd Ste 105, Gardena, CA 90247-4184 | 2018-02-27 |
| 1548231350 | Pacific South Bay Dialysis, LLC | Clinic/Center | 1149 W 190th St, Ste 1004, Gardena, CA 90248-4321 | 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 |
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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.