Montebello Artificial Kidney Center, LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

MONTEBELLO ARTIFICIAL KIDNEY CENTER, LLC

Practice address

3404 W Beverly Blvd
Montebello, CA 90640-1539

Phone

(323) 728-7580

Fax

(323) 728-7590

NPI assigned

Jan 7, 2008

Last updated

Apr 28, 2010By 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

Vijay Dhawan, M.D.NPI 1760426415

Title

Director

Phone

(323) 721-9411

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

Montebello Artificial Kidney CenterCCN 552640

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Sep 28, 2009

Medicare certification status

ActiveFrom the Provider of Services file

Dialysis stations

24

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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.

• Vijay M Dhawan, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Montebello, CA
  • NPI 1760426415
  NPD Authorized official

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Pradip C.P. Chowdhury, M.D.

  • Nephrology Physician
  • Montebello, CA
  • NPI 1053348946

  Dialysis facility

  Care Compare affiliation Name & address match
• Feliciano Antonio Serrano II, M.D.

  • Specialist
  • Huntington Park, CA
  • NPI 1649225558

  Dialysis facility

  Care Compare affiliation Name & address match
• Edgar P Toscano, MD

  • Nephrology Physician
  • Montebello, CA
  • NPI 1972532042

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1199664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272412800000",
    "number": "1790960060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3404 W BEVERLY BLVD",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906401539",
            "telephone_number": "323-728-7580",
            "fax_number": "323-728-7590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3404 W BEVERLY BLVD",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906401539",
            "telephone_number": "323-728-7580",
            "fax_number": "323-728-7590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTEBELLO ARTIFICIAL KIDNEY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-07",
        "last_updated": "2010-04-28",
        "status": "A",
        "authorized_official_last_name": "DHAWAN",
        "authorized_official_first_name": "VIJAY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "323-721-9411",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Montebello, CA
• Providers in Montebello, CA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.