Intercommunity Dialysis Center-la Mirada

Primary specialty

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

Legal business name

INTERCOMMUNITY DIALYSIS CENTER-LA MIRADA

Practice address

15060 Imperial Hwy
La Mirada, CA 90638-1301

Phone

(562) 696-1841

NPI assigned

Dec 12, 2016

Organization subpart

No

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

Authorized official

Name

Delores Gayle Rogers, LCSW

Title

Social Worker

Phone

(562) 696-1841

Specialties & licenses 1

Addresses

Practitioners 1

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

• Shahriare Nasser-Moaddeli, M.D.

  • Nephrology Physician
  • Whittier, CA
  • NPI 1902811391
  NPD

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

{
    "created_epoch": "1481500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481500800000",
    "number": "1114461043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6367",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906096367",
            "telephone_number": "562-696-1841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15060 IMPERIAL HWY",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906381301",
            "telephone_number": "562-696-1841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERCOMMUNITY DIALYSIS CENTER-LA MIRADA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-12",
        "last_updated": "2016-12-12",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "DELORES",
        "authorized_official_middle_name": "GAYLE",
        "authorized_official_title_or_position": "SOCIAL WORKER",
        "authorized_official_telephone_number": "562-696-1841",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sora Hwang
• Annette Hwangbo, LCSW
• Chiagoziem Igweze, RN
• Olisaemeka Arinzechukwu Igweze
• Imperial Primary Care Medical Group
• J & S Management Services LLC
• Tiffany Hope Jackson
• Hyejin Jae, M.D.
• Keith Jamieson, MD
• Janray Home

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in La Mirada, CA
• Providers in La Mirada, 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 Dec 12, 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.