California Kidney Medical Group Inc

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

G83840 Issued in CA

Legal business name

CALIFORNIA KIDNEY MEDICAL GROUP INC

Practice address

18546 Roscoe Blvd
Suite 120
Northridge, CA 91324-4663

Phone

(818) 886-3773

NPI assigned

Aug 6, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Lily Krastein

Title

Administrator

Phone

(805) 433-7507

Specialties & licenses 1

Addresses

Practitioners 4

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

• Rajiv K. Dhamija, M.D.

  • Nephrology Physician
  • Artesia, CA
  • NPI 1396958955
  NPD (past)
• Farshad Malekmehr, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Van Nuys, CA
  • NPI 1710904651
  NPD (past)
• Alan C Mintz, MD

  • Vascular Surgery Physician
  • Thousand Oaks, CA
  • NPI 1396786497
  NPD (past)
• Raul Enrique Ortega, M.D.

  • Vascular Surgery Physician
  • Denton, TX
  • NPI 1295902385
  NPD (past)

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

{
    "created_epoch": "1217980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217980800000",
    "number": "1659537835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 940838",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930940838",
            "telephone_number": "805-433-7507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18546 ROSCOE BLVD",
            "address_2": "SUITE 120",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913244663",
            "telephone_number": "818-886-3773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA KIDNEY MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-06",
        "last_updated": "2008-08-06",
        "status": "A",
        "authorized_official_last_name": "KRASTEIN",
        "authorized_official_first_name": "LILY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "805-433-7507",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "G83840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emelito Tapang Calderon, DDS
• Rafael Calderon, MFT
• California Dermatology Institute PC
• California Dream Home Health Care Inc
• California Home for Seniors
• California MRI Inc
• California New Life Detox and Recovery Homes, Inc.
• California New Life Detox and Recovery Homes, Inc.
• California Rehabilitation and Sports Therapy a California Physical Ther
• California State University Northridge

• Vascular Surgery Physician in Northridge, CA
• Providers in Northridge, CA by specialty
• Vascular Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2008; 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.