NPIMap

Individual provider Active NPI

Eduardo Juan Nam, MD

  • Nephrology Physician
  • Hemet, CA
National Provider Identifier
1578760641
Registry record updated Apr 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A85422 Issued in CA
Practice address
1515 W Florida Ave
Hemet, CA 92543-3817
Phone
(951) 929-1333
Fax
(951) 929-1377
NPI assigned
Jun 30, 2007
Last updated
Apr 18, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X A85422 CA Primary

Addresses

Primary practice location

1515 W Florida Ave
Hemet, CA 92543-3817

Mailing address

1515 W Florida Ave
Hemet, CA 92543-3817
Phone (951) 929-1333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051130000883 CA Practitioner - NephrologyPractitioner - Internal Medicine 4587684923 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Loma Linda University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
California Kidney SpecialistsGroup PAC ID 0345232096, 16 clinicians

Practice addresses (Care Compare)

1335 Cypress St
Suite 205
San Dimas, CA 91773-3538
Phone 90954227772770

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A85422CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Associates Corporation CurrentSince Jan 1, 2021 Accepting new patients
Apex Healthcare Medical Center Inc CurrentSince Dec 29, 2011 Accepting new patients
Apex Healthcare Medical Center Inc CurrentSince Dec 29, 2011 Accepting new patients
Apex Healthcare Medical Center Inc Current Accepting new patients
Physicians of Southern California Inc CurrentSince Mar 18, 2022 Accepting new patients
California Kidney Specialists Nephrology CurrentSince Jan 3, 2022 Accepting new patients
Casa Colina Hospital and Centers for Healthcare Current Accepting new patients
Loma Linda University Medical Center Past Accepting new patients
Hemet Valley Medical Center Past Accepting new patients
San Dimas Community Hospital, Inc. Past Accepting new patients
Ahmc San Gabriel Valley Medical Past Accepting new patients
Bharathi S Vayuvegula MD PHD Inc PastSince Jan 17, 2022 Accepting new patients
Menifee Valley Medical Center Past Accepting new patients

Locations

315 N 3rd Ave
Ste 104
Covina, CA 91723
Phone (626) 331-0133

1624 S Grand Ave
Glendora, CA 91740
Phone (626) 859-2249

1225 E Latham Ave
Ste A
Hemet, CA 92543
Phone (909) 652-8700

1515 W Florida Ave
Hemet, CA 92543
Phone (951) 929-1333

41889 State Highway 74
Hemet, CA 92544
Phone (951) 652-8700

1304 W Holt Blvd
Ste A
Ontario, CA 91762
Phone (626) 859-2249

1150 N Indian Canyon Dr
Palm Springs, CA 92262
Phone (760) 323-6251

3235 E Colorado Blvd
Ste 102
Pasadena, CA 91107
Phone (626) 859-2249

6850 Brockton Ave
Ste 102
Riverside, CA 92506
Phone (626) 859-2249

1500 N Waterman Ave
#B
Sn Bernrdno, CA 92404
Phone (909) 381-1595

399 E Highland Ave
Ste 227
Sn Bernrdno, CA 92404
Phone (909) 381-1595

901 San Bernardino Rd
Ste 104
Upland, CA 91786
Phone (909) 542-2779

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: casacolina@direct.casacolina.org
  • FHIR API: https://fhir-myrecord.cerner.com/r4/5192cc27-2764-47df-a8de-8ad1cf29ade6/

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 13

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1183161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492473600000",
    "number": "1578760641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 W FLORIDA AVE",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925433817",
            "telephone_number": "951-929-1333",
            "fax_number": "951-929-1377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 W FLORIDA AVE",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925433817",
            "telephone_number": "951-929-1333",
            "fax_number": "951-929-1377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAM",
        "first_name": "EDUARDO",
        "middle_name": "JUAN",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-30",
        "last_updated": "2017-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A85422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hemet, CA

Sources for this page

Verify at the official NPI Registry.