Cerritos Dialysis Center LLC

Primary specialty

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

License

930000982 Issued in CA

Legal business name

CERRITOS DIALYSIS CENTER LLC

Practice address

19222 Pioneer Blvd
Cerritos, CA 90703-6601

Phone

(562) 924-9990

Fax

(562) 924-9955

NPI assigned

Jul 18, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Gadsalli Ramaswamy Ravikumar, M.D.

Title

President/Ceo

Phone

(714) 226-0818

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Jayanthi Ravikumar, M.D.

  • Physical Medicine & Rehabilitation Physician
  • La Palma, CA
  • NPI 1679528053
  NPD (past)

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354147200000",
    "number": "1649298522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3356 W BALL RD",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928043702",
            "telephone_number": "714-226-0818",
            "fax_number": "714-226-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19222 PIONEER BLVD",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907036601",
            "telephone_number": "562-924-9990",
            "fax_number": "562-924-9955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CERRITOS DIALYSIS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2012-11-29",
        "status": "A",
        "authorized_official_last_name": "RAVIKUMAR",
        "authorized_official_first_name": "GADSALLI",
        "authorized_official_middle_name": "RAMASWAMY",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "714-226-0818",
        "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": "930000982",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CDC02896F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea Teresa Cerda
• Emilia Cerdas
• Oscar Cerezo
• Cerritos 2020 Optometry a Proffesional Optometric Corporatio
• Cerritos Congregate Living Corporation
• Cerritos Endoscopic Medical Center, Inc.
• Cerritos Eye Medical Center, Inc.
• Cerritos Family Denal Center
• Cerritos Home Care Inc
• Cerritos Medical Center, Inc

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Cerritos, CA
• Providers in Cerritos, 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 Nov 29, 2012; 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.