Organization Active NPI

Center for Interventional Cardiology & Nephrology Med GP Inc

  • Nephrology Physician
  • Los Angeles, CA
National Provider Identifier
1720199797
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
CENTER FOR INTERVENTIONAL CARDIOLOGY & NEPHROLOGY MED GP INC
Practice address
8631 W 3Rd St Ste 815E
Los Angeles, CA 90048-5901
Phone
(310) 659-1770
Fax
(424) 265-5819
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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

Authorized official

Name
Dr. Guita Balakhane, M.D.,NPI 1326027806
Title
Physician
Phone
(310) 652-2744

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
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

8631 W 3Rd St Ste 815E
Los Angeles, CA 90048-5901

Mailing address

8635 W 3Rd St
Ste# 695W
Los Angeles, CA 90048-6101
Phone (310) 652-2744

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090305000229 CA Part B Supplier - Clinic/Group Practice 0143386789 Receives reassigned benefits from 9 practitioners
Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory

Locations

18226 Ventura Blvd
Ste 102
Tarzana, CA 91356
Phone (818) 905-5904

8635 W 3rd St
Ste 695
West Hollywood, CA 90048
Phone (310) 652-2744

8631 W 3rd St
Ste 815E
West Hollywood, CA 90048
Phone (310) 652-3055

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761091200000",
    "number": "1720199797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8635 W 3RD ST",
            "address_2": "STE# 695W",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900486101",
            "telephone_number": "310-652-2744",
            "fax_number": "310-967-2140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8631 W 3RD ST STE 815E",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485901",
            "telephone_number": "310-659-1770",
            "fax_number": "424-265-5819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR INTERVENTIONAL CARDIOLOGY & NEPHROLOGY MED GP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A",
        "authorized_official_last_name": "BALAKHANE",
        "authorized_official_first_name": "GUITA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "310-652-2744",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D.,"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.