NPIMap

Organization Active NPI

Davita Nephrology Medical Associates of Californa Inc

  • Nephrology Physician
  • Whittier, CA
National Provider Identifier
1669436648
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
DAVITA NEPHROLOGY MEDICAL ASSOCIATES OF CALIFORNA INC
Practice address
15141 E Whittier Blvd
Ste 225
Whittier, CA 90603
Phone
(562) 698-3536
Fax
(562) 698-3945
NPI assigned
Apr 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Anthony Efthim Gabriel, MD
Title
Owner President Secretary Treasurer
Phone
(800) 310-4872

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

15141 E Whittier Blvd
Ste 225
Whittier, CA 90603

Mailing address

PO Box 2355
Tacoma, WA 98401
Phone (800) 310-4872

Other identifiers 1

IdentifierTypeStateIssuer
GR0093980MedicaidCA

Other names 1

  • DaVita Renal Specialists of California Medical Corporation Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Davita Nephrology Medical Associates of California Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669436648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2355",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "98401",
            "telephone_number": "800-310-4872",
            "fax_number": "877-328-4923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15141 E WHITTIER BLVD",
            "address_2": "STE 225",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "90603",
            "telephone_number": "562-698-3536",
            "fax_number": "562-698-3945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVITA NEPHROLOGY MEDICAL ASSOCIATES OF CALIFORNA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GABRIEL",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "EFTHIM",
        "authorized_official_title_or_position": "OWNER PRESIDENT SECRETARY TREASURER",
        "authorized_official_telephone_number": "800-310-4872",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0093980",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DaVita Renal Specialists of California Medical Corporation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Whittier, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.