Kidney Dialysis Center of Pismo Beach, LLC

Primary specialty

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

Legal business name

KIDNEY DIALYSIS CENTER OF PISMO BEACH, LLC

Practice address

320 James Way
Suite # 110
Pismo Beach, CA 93449-2813

Phone

(805) 556-0577

Fax

(805) 433-7655

NPI assigned

Jun 19, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Lisa Viral Upponi

Title

Director of Accounts Receivable

Phone

(805) 433-7506

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Scott Anthony Morey Jr., M.D.

  • Nephrology Physician
  • San Luis Obispo, CA
  • NPI 1770661894
  NPD (past)

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185753600000",
    "number": "1518902758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 940838",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930940838",
            "telephone_number": "805-433-7777",
            "fax_number": "805-433-7655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 JAMES WAY",
            "address_2": "SUITE # 110",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934492813",
            "telephone_number": "805-556-0577",
            "fax_number": "805-433-7655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDNEY DIALYSIS CENTER OF PISMO BEACH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-19",
        "last_updated": "2007-07-30",
        "status": "A",
        "authorized_official_last_name": "UPPONI",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "VIRAL",
        "authorized_official_title_or_position": "DIRECTOR OF ACCOUNTS RECEIVABLE",
        "authorized_official_telephone_number": "805-433-7506",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CDC52556",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Terry L. Kaiura, M.D.
• Sacha Karnofsky
• Katherine Marie Kaufmann-Alderete, R.D.
• Ken P Optometry Corp
• Kenneth a Peterson
• Lisa Marie Kruitbosch
• Michael Thomas Laird, M.D.
• Matthew Eren Lanson, MD
• Genene Lara
• Giancarlo Lauriente, DDS

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Pismo Beach, CA
• Providers in Pismo Beach, 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 Jul 30, 2007; 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.