San Dimas Dialysis Center a Medical Corporation

Primary specialty

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

License

550000175 Issued in CA

Legal business name

SAN DIMAS DIALYSIS CENTER A MEDICAL CORPORATION

Doing business as

San Dimas Dialysis Center, Inc.

Practice address

1335 W Cypress Ave
Suite 102
San Dimas, CA 91773-3537

Phone

(909) 542-2900

Fax

(909) 394-1800

NPI assigned

Jul 11, 2006

Last updated

Jun 27, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mojtaba Moghadam, M.D.NPI 1932114733

Title

President

Phone

(909) 542-2900

Specialties & licenses 1

Addresses

Other names 1

• SAN DIMAS DIALYSIS CENTER, INC. Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

San Dimas Dialysis Center, Inc.CCN 552552

Overall star rating

3.0 of 5

Ownership

Profit

Certified

May 12, 2006

Medicare certification status

ActiveFrom the Provider of Services file

Dialysis stations

32

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

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mojtaba Moghadam I, M.D.

  • Nephrology Physician
  • San Dimas, CA
  • NPI 1932114733
  NPD (past) Authorized official
• Claudio H Gallego, M.D.

  • Nephrology Physician
  • San Dimas, CA
  • NPI 1285649962
  NPD (past)

Affiliated clinicians 4

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

• Michael Hien Bien, M.D.

  • Nephrology Physician
  • San Dimas, CA
  • NPI 1689680654

  Dialysis facility

  Care Compare affiliation Name & address match
• Claudio H Gallego, M.D.

  • Nephrology Physician
  • San Dimas, CA
  • NPI 1285649962

  Dialysis facility

  Care Compare affiliation Name & address match
• Mojtaba Moghadam I, M.D.

  • Nephrology Physician
  • San Dimas, CA
  • NPI 1932114733

  Dialysis facility

  Care Compare affiliation Name & address match
• Amna Arif Rizvi, M.D.

  • Nephrology Physician
  • San Dimas, CA
  • NPI 1841483609

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340755200000",
    "number": "1447285275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1335 W CYPRESS AVE",
            "address_2": "SUITE 207",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917733537",
            "telephone_number": "909-542-2777",
            "fax_number": "909-394-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1335 W CYPRESS AVE",
            "address_2": "SUITE 102",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917733537",
            "telephone_number": "909-542-2900",
            "fax_number": "909-394-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN DIMAS DIALYSIS CENTER A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2012-06-27",
        "status": "A",
        "authorized_official_last_name": "MOGHADAM",
        "authorized_official_first_name": "MOJTABA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-542-2900",
        "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": "550000175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SAN DIMAS DIALYSIS CENTER, INC.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• San Dimas Anesthesia Medical Group
• San Dimas Care LLC
• San Dimas Community Hospital, Inc. (San Dimas Community Hospital)
• San Dimas Community Hospital, Inc. (San Dimas Community Hospital)
• San Dimas Counseling, LLC
• San Dimas Elite Senior Home LLC
• San Dimas Emergency Medical Associates Inc.
• San Dimas Family and Sedation Dentistry
• San Dimas Family and Sedation Dentistry
• San Dimas Family Care Inc.

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in San Dimas, CA
• Providers in San Dimas, 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 Jun 27, 2012; 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.