Organization Active NPI

Mohan Dialysis Center of Covina, Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • City of Industry, CA
National Provider Identifier
1558522151
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
MOHAN DIALYSIS CENTER OF COVINA, INC
Practice address
15757 E Valley Blvd
City of Industry, CA 91744-3900
Phone
(626) 333-3801
Fax
(626) 336-1303
NPI assigned
Jun 17, 2008
Organization subpart
Yes
Parent organization
MOHAN DIALYSIS CENTER OF COVINA, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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

Authorized official

Name
Mrs. Anna J Mohan
Title
Business Manager
Phone
(626) 914-5553

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X Primary

Addresses

Primary practice location

15757 E Valley Blvd
City of Industry, CA 91744-3900

Mailing address

638 S Glendora Ave
Glendora, CA 91740-4483
Phone (626) 914-5553

Other names 1

  • mohan dialysis center of industry Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091217000480 CA Part A Provider - End-Stage Renal Disease Facility (ESRD) 5193636546 Practice locations: City of Industry, CA

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2071906Mohan Dialysis Center of Industry15757 East Valley Blvd, City of Industry, CA 91744Certificate of waiverOct 29, 2026

National Provider Directory

National Provider Directory
Tax ID family
Mohan Dialysis Center of Covina Inc3 organizations share this tax ID, including this one
Part of
Mohan Dialysis Center of Covina Inc

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1213660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616025600000",
    "number": "1558522151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "638 S GLENDORA AVE",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917404483",
            "telephone_number": "626-914-5553",
            "fax_number": "626-914-5602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15757 E VALLEY BLVD",
            "city": "CITY OF INDUSTRY",
            "state": "CA",
            "postal_code": "917443900",
            "telephone_number": "626-333-3801",
            "fax_number": "626-336-1303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOHAN DIALYSIS CENTER OF COVINA, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MOHAN DIALYSIS CENTER OF COVINA, INC",
        "enumeration_date": "2008-06-17",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A",
        "authorized_official_last_name": "MOHAN",
        "authorized_official_first_name": "ANNA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "626-914-5553",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "mohan dialysis center of industry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "mohan dialysis center of industry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in City of Industry, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; 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.