Active NPI
Kidney Dialysis Center of Baldwin Hills LLC
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Los Angeles, CA
National Provider Identifier
1104111491
On this page
Key facts
NPPES NPI Registry- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CDC02806F | Medicaid | CA |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pulmonary Disease Physician
- Inglewood, CA
- NPI 1619064912
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.