Indian Wells Valley Dialysis Center

Primary specialty

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

Legal business name

INDIAN WELLS VALLEY DIALYSIS CENTER

Practice address

212 S Richmond Rd
Ridgecrest, CA 93555-4434

Phone

(760) 371-7506

NPI assigned

Apr 23, 2009

Last updated

Apr 24, 2009By 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

Bassam A Hadaya, M.D.

Title

Owner

Phone

(661) 267-7642

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1240444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240531200000",
    "number": "1538303342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1643 E PALMDALE BLVD",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935504847",
            "telephone_number": "661-267-7642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 S RICHMOND RD",
            "city": "RIDGECREST",
            "state": "CA",
            "postal_code": "935554434",
            "telephone_number": "760-371-7506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIAN WELLS VALLEY DIALYSIS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-23",
        "last_updated": "2009-04-24",
        "status": "A",
        "authorized_official_last_name": "HADAYA",
        "authorized_official_first_name": "BASSAM",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "661-267-7642",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Larisa A Hunt
• Celena J Hunter
• James Hwang, MD
• Taylor Danni Ibrahim, DO
• Indian Wells Podiatry Group (California Foot & Ankle Center)
• Indian Wells Valley Dialysis Medical Center Inc
• Delia F Irey, P.A
• Ray N Iskander, MD
• J. Brent Hansen D.D.S. Apc
• Jennifer Lynn Jimenez

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Ridgecrest, CA
• Providers in Ridgecrest, 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 Apr 24, 2009; 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.