Innovative Dialysis Center of West Los Angeles, LLC

Primary specialty

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

Legal business name

INNOVATIVE DIALYSIS CENTER OF WEST LOS ANGELES, LLC

Practice address

1801 S la Cienega Blvd
Suite 100
Los Angeles, CA 90035-4641

Phone

(310) 840-5688

Fax

(310) 840-5690

NPI assigned

Jan 14, 2013

Organization subpart

Yes

Parent organization

U.S. RENAL CARE, INC.As reported in NPPES

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

Authorized official

Name

Thomas L. Weinberg

Title

Authorized Official

Phone

(214) 736-2700

Specialties & licenses 1

Addresses

Other names 1

• U.S. Renal Care West Los Angeles Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

USRC West LA DialysisCCN 052809

Overall star rating

5.0 of 5

Ownership

Profit

Certified

Sep 3, 1997

Medicare certification status

ActiveFrom the Provider of Services file

Chain

US Renal Care, Inc.

Dialysis stations

22

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Innovative Dialysis Center of West Los Angeles LLC2 organizations share this tax ID, including this one

Part of

US Renal Care Inc

Other organizations with this tax ID 1

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

• Innovative Dialysis Center of West Los Angeles, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Los Angeles, CA
  • NPI 1588324966
  NPD tax ID

Affiliated clinicians 5

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Behnoud Beroukhim, M.D.

  • Nephrology Physician
  • Los Angeles, CA
  • NPI 1639477136

  Dialysis facility

  Care Compare affiliation Name & address match
• Solomon F. Bitew, MD

  • Nephrology Physician
  • Los Angeles, CA
  • NPI 1619036217

  Dialysis facility

  Care Compare affiliation Name & address match
• Helder De Paiva, M.D.

  • Nephrology Physician
  • Los Angeles, CA
  • NPI 1174610273

  Dialysis facility

  Care Compare affiliation Name & address match
• Victor Gura, MD

  • Nephrology Physician
  • Beverly Hills, CA
  • NPI 1932296357

  Dialysis facility

  Care Compare affiliation Name & address match
• Ronald P Lang, M.D.

  • Nephrology Physician
  • West Hollywood, CA
  • NPI 1639230550

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1358121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382918400000",
    "number": "1154668986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WORLD TRADE CTR",
            "address_2": "STE 2500",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908310002",
            "telephone_number": "562-495-8075",
            "fax_number": "562-495-8076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 S LA CIENEGA BLVD",
            "address_2": "SUITE 100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900354641",
            "telephone_number": "310-840-5688",
            "fax_number": "310-840-5690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE DIALYSIS CENTER OF WEST LOS ANGELES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "U.S. RENAL CARE, INC.",
        "enumeration_date": "2013-01-14",
        "last_updated": "2013-10-28",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "214-736-2700"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "U.S. Renal Care West Los Angeles Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Inner Milestones Co LLC
• Inner Space Family Therapy
• Deborah Innes-Gomberg
• Innovations Counseling Services
• Innovative Diagnostic Medical Group
• Innovative Dialysis Center of West Los Angeles, LLC
• Innovative Gastroenterology Professional Corporation
• Innovative Medicine
• Innovative Orthopedic Medical Solutions
• Innovative Rehab. Inc

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Los Angeles, CA
• Providers in Los Angeles, 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 Oct 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.