West Coast Renal Medical Group, Inc

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

WEST COAST RENAL MEDICAL GROUP, INC

Practice address

2925 Sycamore Dr
Suite 160
Simi Valley, CA 93065-1207

Phone

(805) 584-0177

Fax

(805) 584-1179

NPI assigned

May 18, 2016

Last updated

Dec 19, 2017By 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

Dr. Jieshi Yan, M.D.NPI 1396744546

Title

President

Phone

(818) 718-2301

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jie Shi Yan, M.D.

  • Nephrology Physician
  • Simi Valley, CA
  • NPI 1396744546
  NPD Authorized official

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

{
    "created_epoch": "1463529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513641600000",
    "number": "1740637875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13990 BEAR FENCE CT",
            "city": "MOORPARK",
            "state": "CA",
            "postal_code": "930215022",
            "telephone_number": "818-718-2301",
            "fax_number": "818-718-2311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2925 SYCAMORE DR",
            "address_2": "SUITE 160",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930651207",
            "telephone_number": "805-584-0177",
            "fax_number": "805-584-1179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST COAST RENAL MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-18",
        "last_updated": "2017-12-19",
        "status": "A",
        "authorized_official_last_name": "YAN",
        "authorized_official_first_name": "JIESHI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-718-2301",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nephrology Physician in Simi Valley, CA
• Providers in Simi Valley, CA by specialty
• Nephrology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2017; 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.