Active NPI
R Sankaram M D a Medical Corporation
- Nephrology Physician
- Fountain Valley, CA
National Provider Identifier
1750675286
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- A25687
- Legal business name
- R SANKARAM M D A MEDICAL CORPORATION
- Practice address
- 11100 Warner Ave
Suite 260
Fountain Valley, CA 92708-7506 - Phone
- (714) 641-6900
- Fax
- (714) 641-3900
- NPI assigned
- Jun 1, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Celine Duong
- Title
- Administration Manager
- Phone
- (714) 721-0848
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | A25687 | CA | Primary |
Addresses
Primary practice location
11100 Warner Ave
Suite 260
Fountain Valley, CA 92708-7506
Mailing address
62 Modena
Irvine, CA 92618-0104
Phone (714) 721-0848
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A256871 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
11100 Warner Ave
Ste 260
Fountain Vly, CA 92708
Phone (714) 641-6900
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Nephrology Physician
- Fountain Valley, CA
- NPI 1710090766
-
- Nephrology Physician
- Fountain Valley, CA
- NPI 1114014438
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1306886400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1749168000000",
"number": "1750675286",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "62 MODENA",
"city": "IRVINE",
"state": "CA",
"postal_code": "926180104",
"telephone_number": "714-721-0848",
"fax_number": "949-387-2500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11100 WARNER AVE",
"address_2": "SUITE 260",
"city": "FOUNTAIN VALLEY",
"state": "CA",
"postal_code": "927087506",
"telephone_number": "714-641-6900",
"fax_number": "714-641-3900"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "R SANKARAM M D A MEDICAL CORPORATION",
"organizational_subpart": "NO",
"enumeration_date": "2011-06-01",
"last_updated": "2025-06-06",
"certification_date": "2025-06-06",
"status": "A",
"authorized_official_last_name": "DUONG",
"authorized_official_first_name": "CELINE",
"authorized_official_title_or_position": "ADMINISTRATION MANAGER",
"authorized_official_telephone_number": "714-721-0848"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Nephrology",
"state": "CA",
"license": "A25687",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A256871",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fountain Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 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.