El Camino Renal Medical Group, Inc

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

EL CAMINO RENAL MEDICAL GROUP, INC

Practice address

515 South Dr
Suite 12
Mountain View, CA 94040-4204

Phone

(650) 988-7944

Fax

(650) 964-3608

NPI assigned

Dec 29, 2005

Organization subpart

No

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

Authorized official

Name

Brian James Carrie, MD

Title

Director

Phone

(650) 988-7944

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509408000000",
    "number": "1770560914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 SOUTH DR",
            "address_2": "SUITE 12",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940404204",
            "telephone_number": "650-988-7944",
            "fax_number": "650-964-3608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 SOUTH DR",
            "address_2": "SUITE 12",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940404204",
            "telephone_number": "650-988-7944",
            "fax_number": "650-964-3608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EL CAMINO RENAL MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-29",
        "last_updated": "2017-10-31",
        "status": "A",
        "authorized_official_last_name": "CARRIE",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "650-988-7944",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ77355Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• El Camino Hospital
• El Camino Hospital Pharmacy
• El Camino Hospital-SNF
• El Camino Pathology Medical Group, Inc
• El Camino Radiologists Medical Group
• El Camino Surgery Center
• El Camino Urology Medical Group, Inc
• Yasmeen Elbanna
• Elements Health Center Inc
• Gabi Sloane Elfenbein, LMFT 39306

• Nephrology Physician in Mountain View, CA
• Providers in Mountain View, CA by specialty
• Nephrology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.