La Palma Dialysis Center LLC

Primary specialty

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

License

080000679 Issued in CA

Legal business name

LA PALMA DIALYSIS CENTER LLC

Practice address

5451 La Palma Ave
Suite 35
La Palma, CA 90623-1728

Phone

(714) 523-5970

Fax

(714) 523-4404

NPI assigned

Jul 18, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Gadsalli Ramaswamy Ravikumar, M.D.

Title

President/Ceo

Phone

(714) 226-0818

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353974400000",
    "number": "1235157116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3356 W BALL RD",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928043702",
            "telephone_number": "714-226-0818",
            "fax_number": "714-226-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5451 LA PALMA AVE",
            "address_2": "SUITE 35",
            "city": "LA PALMA",
            "state": "CA",
            "postal_code": "906231728",
            "telephone_number": "714-523-5970",
            "fax_number": "714-523-4404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA PALMA DIALYSIS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2012-11-27",
        "status": "A",
        "authorized_official_last_name": "RAVIKUMAR",
        "authorized_official_first_name": "GADSALLI",
        "authorized_official_middle_name": "RAMASWAMY",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "714-226-0818",
        "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": "CA",
            "license": "080000679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CDC02627G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jackson Charles Kwitny
• Angela J Kwon, PHARM.D.
• Ji Min Kwon, MPAP, PA-C
• La Palma Acupuncture Wellness
• La Palma Acupuncture Wellness
• La Palma Health Group, Inc.
• La Palma OB GYN Medical Group
• La Palma Physical Therapy & Sports Medicine Corporation
• La Palma Urgent & Family Care
• La Palma Urgent & Family Care Inc.

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in La Palma, CA
• Providers in La Palma, 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 Nov 27, 2012; 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.