Organization Active NPI

Reliance Medical Management, LLC

  • Nephrology Physician
  • Moorpark, CA
National Provider Identifier
1922487560
Registry record updated Jun 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
RELIANCE MEDICAL MANAGEMENT, LLC
Practice address
13990 Bear Fence CT
Moorpark, CA 93021-5022
Phone
(818) 718-2301
Fax
(818) 718-2311
NPI assigned
May 28, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2015

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

Authorized official

Name
Joyce Van Bruck
Title
Owner
Phone
(818) 400-6396

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

13990 Bear Fence CT
Moorpark, CA 93021-5022

Mailing address

PO Box 2160
Moorpark, CA 93020-2160
Phone (818) 718-2301

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1432771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434412800000",
    "number": "1922487560",
    "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": "RELIANCE MEDICAL MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-28",
        "last_updated": "2015-06-16",
        "status": "A",
        "authorized_official_last_name": "VAN BRUCK",
        "authorized_official_first_name": "JOYCE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-400-6396"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moorpark, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2015; 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.