Indian Wells Valley Dialysis Medical Center Inc

Primary specialty

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

Legal business name

INDIAN WELLS VALLEY DIALYSIS MEDICAL CENTER INC

Practice address

212 S Richmond Rd
Ridgecrest, CA 93555-4434

Phone

(760) 371-7506

Fax

(760) 371-7806

NPI assigned

Sep 15, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Ghassan S Dahhan, M.D.

Title

Administrator

Phone

(661) 267-7645

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Bassam A Hadaya, MD

  • Nephrology Physician
  • Lancaster, CA
  • NPI 1801864301
  NPD (past)

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221004800000",
    "number": "1154427243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1643 E PALMDALE BLVD",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935504847",
            "telephone_number": "661-267-7645",
            "fax_number": "661-267-6464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 S RICHMOND RD",
            "city": "RIDGECREST",
            "state": "CA",
            "postal_code": "935554434",
            "telephone_number": "760-371-7506",
            "fax_number": "760-371-7806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIAN WELLS VALLEY DIALYSIS MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2008-09-10",
        "status": "A",
        "authorized_official_last_name": "DAHHAN",
        "authorized_official_first_name": "GHASSAN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "661-267-7645",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "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": "CDC02789F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Celena J Hunter
• James Hwang, MD
• Taylor Danni Ibrahim, DO
• Indian Wells Podiatry Group
• Indian Wells Valley Dialysis Center
• Delia F Irey, P.A
• Ray N Iskander, MD
• J. Brent Hansen D.D.S. Apc
• Jennifer Lynn Jimenez
• Kathleen Anne Johnson, M.A.

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Ridgecrest, CA
• Providers in Ridgecrest, 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 Sep 10, 2008; 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.