Excel Kidney Care Inc a Professional Medical Corporation

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

3692662 Issued in CA

Legal business name

EXCEL KIDNEY CARE INC A PROFESSIONAL MEDICAL CORPORATION

Practice address

1144 Norman Dr Ste 303
Manteca, CA 95336-5925

Phone

(209) 888-4340

Fax

(209) 888-4371

NPI assigned

Nov 6, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Randeep S Bajwa, M.D.

Title

Secretary

Phone

(209) 825-2047

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1446768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691366400000",
    "number": "1356714745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 NORMAN DR STE 104",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953365900",
            "telephone_number": "209-943-0851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1144 NORMAN DR STE 303",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953365925",
            "telephone_number": "209-888-4340",
            "fax_number": "209-888-4371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCEL KIDNEY CARE INC A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-06",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A",
        "authorized_official_last_name": "BAJWA",
        "authorized_official_first_name": "RANDEEP",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "209-825-2047",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "3692662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nephrology Physician in Manteca, CA
• Providers in Manteca, CA by specialty
• Nephrology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; 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.