Organization Active NPI

Queen's Dialysis Unit, Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • West Covina, CA
National Provider Identifier
1710998380
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
QUEEN'S DIALYSIS UNIT, INC.
Practice address
1135 S Sunset Ave
Suite 103
West Covina, CA 91790-3937
Phone
(626) 337-4245
Fax
(626) 480-0761
NPI assigned
Aug 10, 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
Dr. Claudio H. Gallego, M.D.NPI 1285649962
Title
President
Phone
(909) 542-2900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

1135 S Sunset Ave
Suite 103
West Covina, CA 91790-3937

Mailing address

1335 Cypress Street
Suite 207
San Dimas, CA 91773-3537
Phone (909) 542-2900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061011000469 CA Part A Provider - End-Stage Renal Disease Facility (ESRD) 9436155637 Practice locations: West Covina, CA

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
Queens Dialysis Unit, Inc.CCN 052868
Overall star rating
2.0 of 5
Ownership
Profit
Certified
Apr 23, 2001
Medicare certification status
ActiveFrom the Provider of Services file
Dialysis stations
21

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

National Provider Directory

National Provider Directory

Locations

1335 Cypress St
Ste 207
San Dimas, CA 91773
Phone (909) 542-2900

1135 S Sunset Ave
Ste 103
West Covina, CA 91790
Phone (626) 337-4245

Practitioners & affiliated clinicians

Practitioners 2

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

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1710998380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1335 CYPRESS STREET",
            "address_2": "SUITE 207",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917733537",
            "telephone_number": "909-542-2900",
            "fax_number": "909-592-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 S SUNSET AVE",
            "address_2": "SUITE 103",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903937",
            "telephone_number": "626-337-4245",
            "fax_number": "626-480-0761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUEEN'S DIALYSIS UNIT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GALLEGO",
        "authorized_official_first_name": "CLAUDIO",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-542-2900",
        "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": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, 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.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.