San Gabriel Regional Dialysis Training Center, LLC

Primary specialty

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

Legal business name

SAN GABRIEL REGIONAL DIALYSIS TRAINING CENTER, LLC

Practice address

809 S Atlantic Blvd
103
Monterey Park, CA 91754-4756

Phone

(626) 576-8556

Fax

(626) 576-8557

NPI assigned

Feb 2, 2006

Last updated

May 29, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jerry Green

Title

Secretary

Phone

(562) 495-8075

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212019200000",
    "number": "1700858099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WORLD TRADE CTR",
            "address_2": "2500",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908310002",
            "telephone_number": "562-495-8075",
            "fax_number": "562-495-8076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 S ATLANTIC BLVD",
            "address_2": "103",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917544756",
            "telephone_number": "626-576-8556",
            "fax_number": "626-576-8557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN GABRIEL REGIONAL DIALYSIS TRAINING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-02",
        "last_updated": "2008-05-29",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "562-495-8075",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CDC02684G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Virginia Salas, RD
• Benjamin Esai Salinas
• Jennifer Salvador
• San Cristobal Medical Group
• San Gabriel Radiology Medical Group
• San Gabriel Valley Consulting Pathologists Medical Group, Inc.
• San Gabriel Valley Consulting Pathologists Medical Group, Inc.
• San Gabriel Valley Physicians a.C.O. Group, a Medical Corporation (San Gabriel Valley Physicians ACO Medical Group)
• Carla Sanchez
• Gabriela Sanchez

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Monterey Park, CA
• Providers in Monterey Park, 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 May 29, 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.