Kamiah Dialysis LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

License

550002734 Issued in CA

Legal business name

KAMIAH DIALYSIS LLC

Doing business as

Pomona Valley Dialysis

Practice address

2703 S Towne Ave
Pomona, CA 91766-6206

Phone

(909) 590-4930

Fax

(909) 591-8425

NPI assigned

Jan 2, 2014

Last updated

Mar 17, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

John D Winstel

Title

Chief Accounting Officer

Phone

(253) 733-4501

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pomona Valley Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

DaVita Pomona Valley DialysisCCN 552774

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Nov 17, 2014

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

32

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Total Renal Care Inc

  dba Cerritos Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Cerritos, CA
  • NPI 1255681011

  Member Of

  NPD member

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Minna F Huang, M.D.

  • Nephrology Physician
  • Upland, CA
  • NPI 1841447745
  NPD (past)

Affiliated clinicians 4

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Jonardi Handoko, MD

  • Nephrology Physician
  • Upland, CA
  • NPI 1780664581

  Dialysis facility

  Care Compare affiliation Name & address match
• Hla Myint Maung Shin Jian Hwang, M.D.

  • Nephrology Physician
  • Ontario, CA
  • NPI 1356357560

  Dialysis facility

  Care Compare affiliation Name & address match
• Samuel S Liu, MD

  • Nephrology Physician
  • Downey, CA
  • NPI 1912935628

  Dialysis facility

  Care Compare affiliation Name & address match
• Saman Sarani, M.D.

  • Nephrology Physician
  • Upland, CA
  • NPI 1124333141

  Dialysis facility

  Care Compare affiliation Name & address match

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1388620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647475200000",
    "number": "1043631427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L&C DEPT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569",
            "telephone_number": "615-238-3085",
            "fax_number": "800-268-9682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2703 S TOWNE AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917666206",
            "telephone_number": "909-590-4930",
            "fax_number": "909-591-8425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAMIAH DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-02",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-17",
        "status": "A",
        "authorized_official_last_name": "WINSTEL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CHIEF ACCOUNTING OFFICER",
        "authorized_official_telephone_number": "253-733-4501"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "CA",
            "license": "550002734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1043631427",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pomona Valley Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pomona Valley Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Matthew Kakish
• Poonam Kalkat, FNP
• Stephen Marira Kamami
• Kunal Singh Kamboj, D.O.
• Benjamin Michael Kamel, DPM
• Alexandra Kanaan
• David Michael Kandel, PT
• Sugeeth Kandikattu
• Sachi L Kaneko, DO
• Hyerim Kang, M.A., CCC-SLP

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Pomona, CA
• Providers in Pomona, CA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.