Pacific Kidney Care Corp

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

PACIFIC KIDNEY CARE CORP

Practice address

243 Green Valley Rd Ste a
Freedom, CA 95019-3133

Phone

(702) 672-1141

NPI assigned

Nov 9, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Taurino Nunez Avelar, MD

Title

Physician Owner

Phone

(702) 672-1141

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1604880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604880000000",
    "number": "1063014686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 GREEN VALLEY RD STE A",
            "city": "FREEDOM",
            "state": "CA",
            "postal_code": "950193133",
            "telephone_number": "702-672-1141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 GREEN VALLEY RD STE A",
            "city": "FREEDOM",
            "state": "CA",
            "postal_code": "950193133",
            "telephone_number": "702-672-1141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC KIDNEY CARE CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-09",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A",
        "authorized_official_last_name": "AVELAR",
        "authorized_official_first_name": "TAURINO",
        "authorized_official_middle_name": "NUNEZ",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "702-672-1141",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL BOARD OF CALIFORNIA",
            "identifier": "A126407",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nephrology Physician in Freedom, CA
• Providers in Freedom, CA by specialty
• Nephrology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.