Pacific Renal Care Medical Corp

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

PACIFIC RENAL CARE MEDICAL CORP

Practice address

11180 Warner Ave Ste 463
Fountain Valley, CA 92708-7505

Phone

(714) 241-9200

NPI assigned

Oct 4, 2006

Organization subpart

No

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

Authorized official

Name

Joginder S Jodhka, MDNPI 1558379503

Title

President

Phone

(714) 241-9200

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 4

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

• Joginder S Jodhka, MD

  • Nephrology Physician
  • Fountain Valley, CA
  • NPI 1558379503
  Medicare reassignment Care Compare group NPD Authorized official
• Zavier Shawkat Ahmed, M.D.

  • Nephrology Physician
  • Fountain Valley, CA
  • NPI 1255677134
  Medicare reassignment Care Compare group NPD
• Tarun Marwaha, M.D.

  • Nephrology Physician
  • Fountain Valley, CA
  • NPI 1407964976
  Medicare reassignment Care Compare group NPD
• Afsaneh Haftbaradaran Mohammadi, M.D.

  • Nephrology Physician
  • Fountain Valley, CA
  • NPI 1902040009
  Medicare reassignment NPD

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498435200000",
    "number": "1326133448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20230",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927280230",
            "telephone_number": "714-241-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11180 WARNER AVE STE 463",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087505",
            "telephone_number": "714-241-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC RENAL CARE MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2017-06-26",
        "status": "A",
        "authorized_official_last_name": "JODHKA",
        "authorized_official_first_name": "JOGINDER",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-241-9200",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pacific Coast Multi Specialty Surgery, LLC
• Pacific Coast Speech Therapy, Inc
• Pacific Endoscopy and Surgery Center, LLC
• Pacific Endoscopy Center, LLC
• Pacific Pain Managment
• Pacific Sleep Medicine Services Inc
• Susana Maria Paez
• Elliot Page, RBT
• Kea Ja Pai, MD
• Pain Medicine Associates, Inc.

• Nephrology Physician in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Nephrology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.