NPIMap

Organization Active NPI

Nephrology Associates Medical Group, Inc.

  • Specialist
  • Riverside, CA
National Provider Identifier
1093264145
Registry record updated Sep 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
NEPHROLOGY ASSOCIATES MEDICAL GROUP, INC.
Practice address
3660 Park Sierra Dr Ste 203
Riverside, CA 92505-3071
Phone
(951) 687-3200
NPI assigned
Sep 30, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2016

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

Authorized official

Name
Dr. Chao Huang Sun
Title
Co Owner
Phone
(951) 687-3200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

3660 Park Sierra Dr Ste 203
Riverside, CA 92505-3071

Mailing address

PO Box 54130
Los Angeles, CA 90054-0130

Other identifiers 6

IdentifierTypeStateIssuer
GR0071421MedicaidCA
GR0071424MedicaidCA
GR71423MedicaidCA
GR0071420MedicaidCA
GR0071422MedicaidCA
1447200126MedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Nephrology Associates Medical Group Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 40

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1475193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475193600000",
    "number": "1093264145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 54130",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900540130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3660 PARK SIERRA DR STE 203",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925053071",
            "telephone_number": "951-687-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEPHROLOGY ASSOCIATES MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-30",
        "last_updated": "2016-09-30",
        "status": "A",
        "authorized_official_last_name": "SUN",
        "authorized_official_first_name": "CHAO",
        "authorized_official_middle_name": "HUANG",
        "authorized_official_title_or_position": "CO OWNER",
        "authorized_official_telephone_number": "951-687-3200",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0071421",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0071424",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR71423",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0071420",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0071422",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447200126",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2016; 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.