Coachella Kidney Institute, LLC
Organization Active NPI End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Coachella, CA
NPI 1851654552 · NPPES record last updated Feb 20, 2014
Key facts
- NPI
- 1851654552
- Entity type
- Organization (NPI type 2)
- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X
- Legal business name
- COACHELLA KIDNEY INSTITUTE, LLC
- Practice address
- 1413 Sixth Street
Coachella, CA 92236-1711 - Phone
- (760) 391-5300
- Fax
- (760) 391-5800
- NPI assigned
- Jun 19, 2012
- Organization subpart
- No
Authorized official
- Name
- Jambur Eriah Chandrashekar, M.D.
- Title
- Administrator
- Phone
- (760) 347-8181
Practitioners 1
Affiliated clinicians 1
Medicare Care Compare: Dialysis facility
- Listed as
- Coachella Kidney Institute, LLC
- Overall star rating
- ★★★★☆ 4.0 of 5
- Ownership
- Profit
- Certified
- Apr 19, 2013
- Medicare certification status
- Active
- Dialysis stations
- 25
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D2047360 | Coachella Kidney Institute, LLC | Certificate of waiver | Sep 20, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20131212001310 | CA | Part a Provider - End-Stage Renal Disease Facility (ESRD) | 8022245364 | Practice locations: Coachella, CA |
National Provider Directory
Locations
1413 6th St
Coachella, CA 92236
Phone (760) 391-5300
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | Yes |
Addresses
Primary practice location
1413 Sixth Street
Coachella, CA 92236-1711
Mailing address
1413 Sixth Street
Coachella, CA 92236-1711
Phone (760) 391-5300
Other providers in Coachella, CA
- CJ Professional Corporation
- Mitchell David Claire
- Clinica Coachella, Inc
- Clinica Medica del Valle, Inc.
- Clinicas de Salud del Pueblo, Inc
- Coachella Valley Parents
- Coachella Valley Rehabilitation
- Janelle Colangelo
- Jeffrey Contreras Sr.
- Prajedes Elena Corrales
All providers in Coachella, CA · End-Stage Renal Disease (ESRD) Treatment Clinic/Center in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 20, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.