California Kidney Medical Group, Inc

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

CALIFORNIA KIDNEY MEDICAL GROUP, INC

Practice address

13990 Bear Fence CT
Moorpark, CA 93021-5022

Phone

(818) 718-2301

Fax

(818) 718-2311

NPI assigned

Sep 11, 2006

Last updated

Nov 30, 2016By 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

Joyce Van Bruck

Title

Administrator

Phone

(818) 400-6396

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 6

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.

• Edgar Allan Musngi, M.D.

  • Nephrology Physician
  • Torrance, CA
  • NPI 1871523563
  Medicare reassignment Care Compare group NPD
• Hamid Sadeghi, M.D.

  • Nephrology Physician
  • Van Nuys, CA
  • NPI 1184624785
  Medicare reassignment Care Compare group NPD
• Salah Sonbol, M.D.

  • Nephrology Physician
  • Thousand Oaks, CA
  • NPI 1922008119
  Medicare reassignment Care Compare group NPD
• Jie Shi Yan, M.D.

  • Nephrology Physician
  • Simi Valley, CA
  • NPI 1396744546
  Medicare reassignment Care Compare group NPD
• Shashank Kailash, MD

  • Nephrology Physician
  • Snellville, GA
  • NPI 1013441468

  CA

  Medicare reassignment Care Compare group
• Michael Warren Todd Shwayder, M.D.

  • Specialist
  • Los Angeles, CA
  • NPI 1598783185

  Nephrology

  Medicare reassignment NPD

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480464000000",
    "number": "1760586705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2160",
            "city": "MOORPARK",
            "state": "CA",
            "postal_code": "930202160",
            "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": "13990 BEAR FENCE CT",
            "city": "MOORPARK",
            "state": "CA",
            "postal_code": "930215022",
            "telephone_number": "818-718-2301",
            "fax_number": "818-718-2311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA KIDNEY MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-11",
        "last_updated": "2016-11-30",
        "status": "A",
        "authorized_official_last_name": "VAN BRUCK",
        "authorized_official_first_name": "JOYCE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "818-400-6396"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carrie Burgert, PT, DPT
• Burts Pharmacy Moorpark
• Burts Pharmacy Moorpark
• Ca Ya Services LLC (Newport Institute-Pimlico)
• Ca Ya Services LLC (Newport Institute-Read)
• Liliana Camacho, PA-C
• Marie Campbell, FNP-BC
• Katrina Camus
• David Canale, DDS
• Kimberly Cano

• Nephrology Physician in Moorpark, CA
• Providers in Moorpark, CA by specialty
• Nephrology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2016; 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.