NPIMap

Organization Active NPI

Valley Internal Medicine & Nephrology Medical Group

  • Nephrology Physician
  • Van Nuys, CA
National Provider Identifier
1659305118
Registry record updated May 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
VALLEY INTERNAL MEDICINE & NEPHROLOGY MEDICAL GROUP
Practice address
15211 Vanowen St
Suite 315
Van Nuys, CA 91405-3606
Phone
(818) 787-2410
Fax
(818) 756-0723
NPI assigned
Jul 10, 2006
Last updated
May 25, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2010

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

Authorized official

Name
Paula Martinez
Title
Credentialing
Phone
(818) 908-8048

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X Primary

Addresses

Primary practice location

15211 Vanowen St
Suite 315
Van Nuys, CA 91405-3606

Mailing address

5805 Sepulveda Blvd
Suite 610
Van Nuys, CA 91411-2546
Phone (818) 908-8048

Other identifiers 1

IdentifierTypeStateIssuer
GR0063960MedicaidCA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274745600000",
    "number": "1659305118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5805 SEPULVEDA BLVD",
            "address_2": "SUITE 610",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914112546",
            "telephone_number": "818-908-8048",
            "fax_number": "818-908-8072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15211 VANOWEN ST",
            "address_2": "SUITE 315",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914053606",
            "telephone_number": "818-787-2410",
            "fax_number": "818-756-0723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY INTERNAL MEDICINE & NEPHROLOGY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2010-05-25",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "PAULA",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "818-908-8048"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0063960",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2010; 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.