NPIMap

Organization Active NPI

Nephron Dialysis Center of Lakewood LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Long Beach, CA
National Provider Identifier
1649298530
Registry record updated Nov 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
930000886 Issued in CA
Legal business name
NEPHRON DIALYSIS CENTER OF LAKEWOOD LLC
Practice address
5820 Downey Avenue
Long Beach, CA 90805-4517
Phone
(562) 663-0788
Fax
(562) 663-0794
NPI assigned
Jul 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2012

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

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 930000886 CA Primary

Addresses

Primary practice location

5820 Downey Avenue
Long Beach, CA 90805-4517

Mailing address

3356 W. Ball Road
Suite 216
Anaheim, CA 92804-3702
Phone (714) 226-0818

Other identifiers 1

IdentifierTypeStateIssuer
CDC02788GMedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Springdale Dialysis758 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

5750 Downey Ave
Ste 203
Lakewood, CA 90712
Phone (562) 200-0334

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353974400000",
    "number": "1649298530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3356 W. BALL ROAD",
            "address_2": "SUITE 216",
            "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": "5820 DOWNEY AVENUE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908054517",
            "telephone_number": "562-663-0788",
            "fax_number": "562-663-0794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEPHRON DIALYSIS CENTER OF LAKEWOOD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2012-11-27",
        "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": "930000886",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CDC02788G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 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.