Organization Active NPI

Kidney Dialysis Center of Baldwin Hills LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1104111491
Registry record updated Aug 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
KIDNEY DIALYSIS CENTER OF BALDWIN HILLS LLC
Practice address
3705 S la Brea Ave
Los Angeles, CA 90016-5309
Phone
(323) 293-4488
Fax
(323) 293-4499
NPI assigned
Jun 14, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2011

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

Authorized official

Name
Manisha Patel
Title
Ar Director
Phone
(805) 433-7555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X Primary

Addresses

Primary practice location

3705 S la Brea Ave
Los Angeles, CA 90016-5309

Mailing address

PO Box 940838
Simi Valley, CA 93094-0838
Phone (805) 433-7777

Other identifiers 1

IdentifierTypeStateIssuer
CDC02806FMedicaidCA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1308009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312502400000",
    "number": "1104111491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 940838",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930940838",
            "telephone_number": "805-433-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3705 S LA BREA AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900165309",
            "telephone_number": "323-293-4488",
            "fax_number": "323-293-4499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDNEY DIALYSIS CENTER OF BALDWIN HILLS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-14",
        "last_updated": "2011-08-05",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "MANISHA",
        "authorized_official_title_or_position": "AR DIRECTOR",
        "authorized_official_telephone_number": "805-433-7555"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CDC02806F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2011; 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.